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Article first published online: 6 AUG 2004
Published 2004 by the American Cancer Society
Supplement: Promoting Cancer Screening: Lessons Learned and Future Directions for Research and Practice
Volume 101, Issue Supplement S5, pages 1188–1200, 1 September 2004
How to Cite
Bastani, R., Yabroff, K. R., Myers, R. E. and Glenn, B. (2004), Interventions to improve follow-up of abnormal findings in cancer screening. Cancer, 101: 1188–1200. doi: 10.1002/cncr.20506
This article is a U.S. Government work and, as such, is in the public domain in the United States of America.
The opinions expressed herein do not necessarily reflect the views of the National Cancer Institute or the U.S. Government.
- Issue published online: 18 AUG 2004
- Article first published online: 6 AUG 2004
- Manuscript Accepted: 26 MAY 2004
- Manuscript Revised: 24 MAY 2004
- Manuscript Received: 22 APR 2004
- abnormal findings;
- cancer screening;
- methodologic issues
The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care. Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and policy-level correlates. The majority of intervention studies to increase follow-up receipt have focused on patient-level factors and have targeted follow-up of abnormal Papanicolaou smears. Insufficient information is available regarding the effectiveness of provider, practice, or policy-level interventions. Standard definitions of what constitutes appropriate follow-up are lacking, which severely limit comparability of findings across studies. The validity of various methods of obtaining outcome data has not been clearly established. More research is needed on interventions targeting provider, system, and policy-level factors, particularly interventions focusing on follow-up of colorectal and breast abnormalities. Standardization of definitions and measures is needed to facilitate comparisons across studies. Cancer 2004. Published 2004 by the American Cancer Society.