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Delivering colonoscopy screening for low-income populations in Suffolk County: Strategies, outcomes, and benchmarks.
MedLine Citation:
PMID:  23868478     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Current and pending legislation provides colorectal cancer screening reimbursement for previously uninsured populations. Colonoscopy is currently the screening method most frequently recommended by physicians for insured patients. The experience of the SCOPE (Suffolk County Preventive Endoscopy) demonstration project (Project SCOPE) at Stony Brook University Medical Center provides a model for delivering colonoscopy screening to low-income populations to meet anticipated increasing demands.
METHODS: Project SCOPE, based in the Department of Preventive Medicine, featured internal collaboration with the academic medical center's large gastroenterology practice and external collaboration with the Suffolk County Department of Health Services' network of community health centers. Colonoscopies were performed by faculty gastroenterologists or supervised fellows. Measures of colonoscopy performance were compared with quality indicators and differences between faculty and supervised fellows were identified.
RESULTS: During a 40-month screening period, 800 initial colonoscopies were performed. Approximately 21% of women screened were found to have adenomatous polyps compared with 36% of men. Five cancers were detected. The majority of the population screened (70%) were members of minority populations. African American individuals had a higher percentage of proximally located adenomas (78%) compared with white individuals (65%) and Hispanics (49%), based on the location of the most advanced lesion. Hispanic individuals had a 36% lower risk of adenomas compared with white individuals. Performance measures including the percentage of procedures with adequate bowel preparation, cecum reached, scope withdrawal time, and adenoma detection rate met quality benchmarks when performed by either faculty or supervised fellows.
CONCLUSIONS: Project SCOPE's operational strategies demonstrated a feasible method for an academic medical center to provide high-quality screening colonoscopy for low-income populations. Cancer 2013;119(15 suppl):2842-8. © 2013 American Cancer Society.
Authors:
Dorothy S Lane; Catherine R Messina; Mary F Cavanagh; Joseph C Anderson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer     Volume:  119 Suppl 15     ISSN:  1097-0142     ISO Abbreviation:  Cancer     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2842-8     Citation Subset:  AIM; IM    
Copyright Information:
© 2013 American Cancer Society.
Affiliation:
Department of Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York.
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