October 07, 2004
CHAPEL HILL — At least one-third of deaths from colorectal cancer could be prevented if people over age 50 were regularly screened for the disease, the U.S. Centers for Disease Control and Prevention has reported.The CDC recently awarded a $2.5 million grant to researchers at the University of North Carolina at Chapel Hill’s Lineberger Comprehensive Cancer Center and Emory University’s Rollins School of Public Health to conduct a randomized trial aimed at increasing screening rates in health-plan members. Aetna, one of the nation’s largest health insurers, is participating in the grant.

Colorectal cancer is the second leading cause of cancer mortality nationwide, with the estimated number of deaths exceeding 57,000 annually. The U.S. Preventive Services Task Force, an independent panel of experts in primary care and prevention, recommends that adults ages 50 and older with an average risk of colorectal cancer be screened periodically through the fecal occult blood test, flexible sigmoidoscopy, colonoscopy or double contrast barium enema.

The UNC-Emory research team will conduct a randomized trial of members enrolled in an Aetna health plan who receive primary care through physician group practices in Georgia and North Carolina, to determine the effectiveness of community- and clinic-based behavioral interventions in increasing colorectal cancer screening in populations of health-plan members.

The study will test a program combining videotape-based decision aid and “academic detailing,” which involves working closely with physician practices to prepare them for increased patient demand for screening.

Some of the practices and their patients between ages 52 and 75 will participate in the program, and others will receive the routine reminders that Aetna sends to all its members who are overdue for screening. The study will continue for up to two years among still-unscreened participants.

The main outcome will be whether or not the participants receive one of the recommended methods of colorectal cancer screening.

“This study has the potential to make dramatic differences in screening rates among health-plan members,” said Dr. Michael Pignone, assistant professor of medicine at UNC’s School of Medicine, member of UNC Lineberger and UNC’s principal investigator for the project.

He added that the UNC team looked forward to working with colleagues at Emory and Aetna and to developing novel ways to reduce deaths from colon cancer.

“Not only will it help us establish systems to increase screening that will fulfill recommended requirements, but it also will help us forge collaborative relationships between public health and health-care researchers and the affected communities of health plans and health-care providers,” said Dr. Karen Glanz, professor of behavioral sciences and health education at the Rollins School of Public Health and a Georgia Cancer Coalition Distinguished Research Scholar.

“The project also will improve our understanding of how screening promotion interventions work in both white and black populations.”

Glanz is the project’s principal investigator. Other investigators on the study team include Dr. Barbara K. Rimer, deputy director of population sciences at UNC Lineberger and Alumni distinguished professor of health behavior and health education at UNC’s School of Public Health; and Dr. Tracy L. Scott, research assistant professor at the Rollins School of Public Health.

The research is being conducted as a collaborative partnership with Aetna’s Southeast region through the Emory Center on Health Outcomes and Quality, a multidisciplinary health-care research group formed to measure and evaluate health-care quality.

“Aetna is pleased to work with two leading research institutions in this effort to increase the number of members who receive this critical preventive screening service,” said Dr. Charles M. Cutler, head of National Quality Management for Aetna.

“Our Southeast region quality and medical economics teams look forward to beginning this important work.”

 

Note: Contact Pignone at Michael_Pignone@med.unc.edu.

UNC Lineberger contact: Dianne Shaw, (919) 966-5909 or dgs@med.unc.edu

News Services contact: Deb Saine, (919) 962-8415 or deborah_saine@unc.edu

 

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