Colorectal Cancer Screening Among Patients who Receive Medical and Dental Care at an Urban Community Health Center
- 3 Downloads
Colorectal cancer (CRC) screening rates remain subpar, particularly among underserved populations. As the role of health care providers evolves, it has been suggested that dentists could play a larger role in preventive health. Building on this concept, dental visits could serve as an additional touchpoint for CRC screening outreach. The primary goal of this study was to compare CRC screening rates among patients who receive both dental and medical care to those who only receive medical care at an urban community health center in order to inform future CRC screening intervention development. We conducted a retrospective medical and dental record data abstraction of all patients meeting the criteria for CRC screening who had a medical and/or dental appointment within the last 2 years. A total of 1081 eligible patients were identified—250 in the dental and medical group and 831 in the medical only group. The patient population was largely black, female, and publicly insured. Among the dental and medical group patients, 36% were up to date on CRC screening compared to 22% among the medical only group (p < 0.001). In addition, the medical and dental group patients had higher screening rates in all other preventive health measures analyzed (p < 0.001). Despite higher screening rates among patients who received both dental and medical care, overall rates were very low. Further screening outreach is needed in this population, and engaging patients at dental visits may be one approach.
KeywordsColorectal cancer Screening Cancer prevention Dental care Community health
Compliance with Ethical Standards
Conflicts of interest
The authors declare that they have no conflict of interest.
- 1.American Cancer Society. (2019). Cancer facts & figures 2019. Atlanta: American Cancer Society. Retrieved October 17, 2018 from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf.
- 2.White, A., Joseph, D., Rim, S. H., Johnson, C. J., Coleman, M. P., & Allemani, C. (2017). Colon cancer survival in the united states by race and stage (2001–2009): Findings from the CONCORD-2 study. Cancer,123(24 Suppl), 5014–5036. https://doi.org/10.1002/cncr.31076.CrossRefPubMedPubMedCentralGoogle Scholar
- 3.American Cancer Society. (2017). Colorectal cancer facts & figures 2017–2019. Atlanta: American Cancer Society. Retrieved October 17, 2018 from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2017-2019.pdf.
- 4.US Preventive Services Task Force, Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Davidson, K. W., Epling, J. W., Jr., et al. (2016). Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA,315(23), 2564–2575. https://doi.org/10.1001/jama.2016.5989.CrossRefGoogle Scholar
- 5.Doubeni, C. A., Laiyemo, A. O., Reed, G., Field, T. S., & Fletcher, R. H. (2009). Socioeconomic and racial patterns of colorectal cancer screening among medicare enrollees in 2000 to 2005. Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology,18(8), 2170–2175. https://doi.org/10.1158/1055-9965.EPI-09-0104.CrossRefGoogle Scholar
- 6.Mehta, S. J., Jensen, C. D., Quinn, V. P., Schottinger, J. E., Zauber, A. G., Meester, R., et al. (2016). Race/ethnicity and adoption of a population health management approach to colorectal cancer screening in a community-based healthcare system. Journal of General Internal Medicine,31(11), 1323–1330. https://doi.org/10.1007/s11606-016-3792-1.CrossRefPubMedPubMedCentralGoogle Scholar
- 7.Gupta, S., Halm, E. A., Rockey, D. C., Hammons, M., Koch, M., Carter, E., et al. (2013). Comparative effectiveness of fecal immunochemical test outreach, colonoscopy outreach, and usual care for boosting colorectal cancer screening among the underserved: A randomized clinical trial. JAMA Internal Medicine,173(18), 1725–1732.PubMedPubMedCentralGoogle Scholar
- 9.Robbins, A. S., Siegel, R. L., & Jemal, A. (2012). Racial disparities in stage-specific colorectal cancer mortality rates from 1985 to 2008. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology,30(4), 401–405. https://doi.org/10.1200/JCO.2011.37.5527.CrossRefGoogle Scholar
- 12.Gupta, S., Sussman, D. A., Doubeni, C. A., Anderson, D. S., Day, L., Deshpande, A. R., et al. (2014). Challenges and possible solutions to colorectal cancer screening for the underserved. Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/dju032.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Potter, M. B., Phengrasamy, L., Hudes, E. S., McPhee, S. J., & Walsh, J. M. (2009). Offering annual fecal occult blood tests at annual flu shot clinics increases colorectal cancer screening rates. Annals of Family Medicine,7(1), 17–23. https://doi.org/10.1370/afm.934.CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Katz, M. L., Fisher, J. L., Fleming, K., & Paskett, E. D. (2012). Patient activation increases colorectal cancer screening rates: A randomized trial among low-income minority patients. Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology,21(1), 45–52. https://doi.org/10.1158/1055-9965.EPI-11-0815.CrossRefGoogle Scholar
- 22.Family Practice and Counseling Network. (2019a). About. Retrieved December 10, 2018 from https://www.fpcn.com/about/.
- 23.Family Practice and Counseling Network. (2019b). Faq. Retrieved December 10, 2018 from https://www.fpcn.com/about/faq/.
- 26.Grohskopf, L. A., Sokolow, L. Z., Broder, K. R., Walter, E. B., Bresee, J. S., Fry, A. M., et al. (2017). Prevention and control of seasonal influenza with vaccines: Recommendations of the advisory committee on immunization practices—United States, 2017–18 influenza season. MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report. Recommendations and Reports,66(2), 1–20. https://doi.org/10.15585/mmwr.rr6602a1.CrossRefPubMedGoogle Scholar
- 27.Tomczyk, S., Bennett, N. M., Stoecker, C., Gierke, R., Moore, M. R., Whitney, C. G., et al. (2014). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥ 65 years: Recommendations of the advisory committee on immunization practices (ACIP). MMWR. Morbidity and Mortality Weekly Report,63(37), 822–825.PubMedPubMedCentralGoogle Scholar
- 28.Department of Health and Human Services, Office of the Secretary. (2019). Notice 84 FR 1167 update of the HHS poverty guidelines: A notice by the health and human services department on 02/01/2019. (Notice No. 2019-00621). Department of Health and Human Services. Retrieved March 8, 2019 from https://www.federalregister.gov/documents/2019/02/01/2019-00621/annual-update-of-the-hhs-poverty-guidelines.
- 29.National Colorectal Cancer Roundtable. (2019). Achieving 80% colorectal cancer screening rates in every community. Retrieved February 22, 2019 from http://nccrt.org/80-in-every-community/.