Study
PLCO
(Learn more about this study)
Project ID
2009-0023
Initial CDAS Request Approval
Apr 30, 2009
Title
Factors Associated with the Timing of Follow-up After an Abnormal Cancer Screening
Summary
The potential of screening to reduce cancer related mortality and morbidity is dependent upon adequate follow-up of screening results. It has been well documented that there are often lengthy delays between the finding of an abnormal screening result and clinical follow-up. At a population level, these delays are likely to contribute to suboptimal treatment outcomes, although the magnitude of this contribution remains unknown. The PLCO Study provides a unique opportunity to systematically examine and describe the time interval from abnormal cancer screening to follow-up care for a variety of cancer types for which little is known. The large scale and multi-center design of PLCO also offers numerous advantages for such a study because it incorporates diversity at all four of the levels thought to affect follow-up time – policy (differences across centers in State health policies); health care systems; individual providers; and patients. As a clinical trial, the study also utilizes explicit definitions of "abnormal" results and "follow-up" care. All patients are followed over time, test results are systematically recorded, as are descriptions and timing of follow-up care. The overall goal of this study is to identify factors associated with delays in follow-up for abnormal cancer screening exams that can inform subsequent interventions to reduce such delays and improve the quality of cancer care.
Aims
Factors associated with delays in follow-up care after abnormal cancer screening have primarily been studied in the context of breast and cervical cancer, and little is known about the extent to which delays in follow-up care exist for PLCO cancers, or factors associated with such delays. The specific aims of this descriptive study are to: 1. Describe the number of days (mean, median and range) from abnormal screen to follow-up for each of the PLCO cancers, and 2. Assess the relative improtance of demographic, socioeconomic and other potentially relevant factors (i.e., family history of cancer, clinical characteristics, previous cancer screening history) with regard to length of time from abnormal screening to follow-up, for each of the PLCO cancers. Based on similar work that has been done in the areas of breast and cervical cancer, we hypothesize that: a) there are delays in clinical follow-up of abnormal PLCO cancer screens for a significant proportion (>=5%) of the study population; and b) delays are associated with lower socioeconomic status and occur more often with minority patients.
Collaborators
Bradley Willcox, MD (PHRI)
Bruce Kessel, MD (PHRI)
Kevin Dodd (DCP, NCI)
Frank Tabrah, MD (PHRI)
Lance Yokochi, MD (PHRI)
Lois Lamerato, PhD (Henry Ford Health Systems)
Qimei He, PhD (PHRI)
Vicki Shambaugh, MA, MPH (PHRI)
