Table 2. FQHC CRC Screening Information by State.
| Four States | Iowa | Minnesota | South Dakota | Wisconsin | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
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| n = 44 | n = 12 | n = 12 | n = 6 | n = 14 | ||||||
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| Yes (%) | m | Yes (%) | m | Yes (%) | m | Yes (%) | m | Yes (%) | m | |
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| *Clinic policy for colorectal cancer (CRC) screening | 27 (61) | 44 | 5 (42) | 12 | 11 (92) | 12 | 4 (67) | 6 | 7 (50) | 14 |
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| a. Written CRC screening policy | 14 (52) | 27 | 2 (40) | 5 | 7 (64) | 11 | 3 (75) | 4 | 2 (29) | 7 |
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| Electronic medical record (EMR) | 34 (79) | 43 | 6 (50) | 12 | 11 (92) | 12 | 5 (100) | 5 | 12 (86) | 14 |
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| a. EMR can query patients due for CRC screening | 23 (68) | 34 | 5 (83) | 6 | 8 (73) | 11 | 3 (60) | 5 | 7 (58) | 12 |
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| b. EMR can query patients up-to-date for CRC screening | 19 (61) | 31 | 5 (83) | 6 | 7 (70) | 10 | 2 (50) | 4 | 5 (45) | 11 |
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| At visit, patients routinely asked: | ||||||||||
| a. Completed CRC screening | 25 (61) | 41 | 8 (73) | 11 | 5 (45) | 11 | 4 (67) | 6 | 8 (62) | 13 |
| b. Hx. ulcerative colitis or Crohn's Dis. | 10 (25) | 40 | 3 (30) | 10 | 3 (27) | 11 | 2 (33) | 6 | 2 (15) | 13 |
| c. Immediate family with CRC or polyps | 27 (66) | 41 | 9 (82) | 11 | 7 (64) | 11 | 5 (83) | 6 | 6 (46) | 13 |
| d. Distant relative with CRC or polyps | 18 (44) | 41 | 7 (64) | 11 | 4 (36) | 11 | 3 (50) | 6 | 4 (31) | 13 |
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| Clinic personnel help to encourage screening | 26 (59) | 44 | 9 (75) | 12 | 7 (58) | 12 | 2 (33) | 6 | 8 (57) | 14 |
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| CRC screening test offered to patients 50 years or older: | ||||||||||
| a. FOBT | 34 (77) | 44 | 11 (92) | 12 | 10 (83) | 12 | 5 (83) | 6 | 8 (57) | 14 |
| *b. FIT | 18 (41) | 44 | 1 (8) | 12 | 5 (42) | 12 | 4 (67) | 6 | 8 (57) | 14 |
| c. Flexible sigmoidoscopy | 5 (11) | 44 | 2 (17) | 12 | 2 (17) | 12 | 0 (0) | 6 | 1 (7) | 14 |
| d. Colonoscopy | 28 (64) | 44 | 7 (58) | 12 | 9 (75) | 12 | 3 (50) | 6 | 9 (64) | 14 |
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| Clinic provides FOBT or FIT to patients 50 years and older | 41 (93) | 44 | 9 (75) | 12 | 12 (100) | 12 | 6 (100) | 6 | 14 (100) | 14 |
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| a. Clinic tracks return of FOBTs and FITs | 26 (63) | 41 | 6 (67) | 9 | 7 (58) | 12 | 5 (83) | 6 | 8 (57) | 14 |
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| b. Patient receives call if FOBT or FIT not returned | 12 (34) | 35 | 3 (38) | 8 | 5 (63) | 8 | 1 (17) | 6 | 3 (23) | 13 |
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| c. Patient receives letter if FOBT or FIT not returned | 9 (26) | 35 | 3 (38) | 8 | 3 (38) | 8 | 1 (17) | 6 | 2 (15) | 13 |
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| d. Patient offered colonoscopy when FOBT or FIT positive | 38 (97) | 39 | 9 (100) | 9 | 11 (100) | 11 | 5 (100) | 5 | 13 (93) | 14 |
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| e. Clinic has system to offer FOBT annually | 20 (54) | 37 | 3 (43) | 7 | 6 (55) | 11 | 3 (60) | 5 | 8 (57) | 14 |
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| Clinic offers CRC testing to patients younger than 50 if they have CRC risk factors | 38 (86) | 44 | 10 (83) | 12 | 11 (92) | 12 | 5 (83) | 6 | 12 (86) | 14 |
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| *a. FOBT | 25 (66) | 38 | 9 (90) | 10 | 6 (55) | 11 | 5 (100) | 5 | 5 (42) | 12 |
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| b. FIT | 14 (37) | 38 | 1 (10) | 10 | 4 (36) | 11 | 3 (60) | 5 | 6 (50) | 12 |
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| c. Flexible sigmoidoscopy | 4 (11) | 38 | 2 (20) | 10 | 0 (0) | 11 | 1 (20) | 5 | 1 (8) | 12 |
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| d. Colonoscopy | 26 (68) | 38 | 7 (70) | 10 | 7 (64) | 11 | 3 (60) | 5 | 9 (75) | 12 |
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| Clinic refers pts. for colonoscopy | 43 (98) | 44 | 12 (100) | 12 | 12 (100) | 12 | 6 (100) | 6 | 13 (93) | 14 |
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| Main barriers to providing CRC screening: | ||||||||||
| a. Lack of time | 18 (41) | 44 | 7 (58) | 12 | 3 (25) | 12 | 2 (33) | 6 | 6 (43) | 14 |
| b. Lack of funding for FOBT | 7 (16) | 44 | 4 (33) | 12 | 0 (0) | 12 | 0 (0) | 6 | 3 (21) | 14 |
| c. Lack of time for personnel to explain test | 10 (23) | 44 | 5 (42) | 12 | 1 (8) | 12 | 0 (0) | 6 | 4 (29) | 14 |
| *d. Language barrier | 12 (27) | 44 | 6 (50) | 12 | 4 (33) | 12 | 2 (33) | 6 | 0 (0) | 14 |
| e. Lack of appropriate patient CRC screening education material | 12 (27) | 44 | 4 (33) | 12 | 4 (33) | 12 | 1 (17) | 6 | 3 (21) | 14 |
| f. Inability to provide colonoscopy for patients with positive FOBT or FIT | 26 (59) | 44 | 9 (75) | 12 | 6 (50) | 12 | 2 (33) | 6 | 9 (64) | 14 |
| g. Inability to provide colonoscopy for patients with colon symptoms | 24 (55) | 44 | 7 (58) | 12 | 6 (50) | 12 | 2 (33) | 6 | 9 (64) | 14 |
| h. No CRC screening tracking system | 18 (41) | 44 | 7 (58) | 12 | 2 (17) | 12 | 2 (33) | 6 | 7 (50) | 14 |
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| %(SD) | m | %(SD) | m | %(SD) | m | %(SD) | m | %(SD) | m | |
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| Estimated Percentage of patients with up-to-date CRC screening | 34.94 (21.01) | 33 | 30.27 (21.33) | 11 | 34.0 (22.70) | 8 | 38.0 (25.15) | 5 | 39.78 (19.17) | 9 |
Denominator for all percentages is respective m.
m = number of valid responses
SD = Standard deviation
*
Fisher's exact, p-value ≤ 0.05