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Research ArticleOriginal Research

A Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Richard G. Roetzheim, Lisa K. Christman, Paul B. Jacobsen, Alan B. Cantor, Jennifer Schroeder, Rania Abdulla, Seft Hunter, Thomas N. Chirikos and Jeffrey P. Krischer
The Annals of Family Medicine July 2004, 2 (4) 294-300; DOI: https://doi.org/10.1370/afm.101
Richard G. Roetzheim
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Lisa K. Christman
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Paul B. Jacobsen
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Alan B. Cantor
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Jennifer Schroeder
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Rania Abdulla
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Seft Hunter
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Thomas N. Chirikos
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Jeffrey P. Krischer
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Article Figures & Data

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    Table 1.

    Characteristics by Group at Baseline, (N = 1,196)

    ControlIntervention
    Clinical CharacteristicsNo.%No.%PValue
    *Among patients who were eligible.
    Group59649.860050.2
    Sex.88
        Male12921.613222.0
        Female46778.446878.0
    Age, years.38
        50–5621235.623238.7
        57–6319632.919933.1
        64–7518831.516928.3
    Race-ethnicity.0009
        African American14424.220434.0
        White30751.527245.3
        Hispanic14524.312420.7
    Marital status.003
        Married14223.818931.5
        Unmarried45476.241168.5
    Primary language.23
        English46477.848480.7
        Non-English (Spanish)13222.211619.3
    Health insurance.48
        County program35459.434657.7
        Medicaid8313.910116.8
        Medicare12220.511218.7
        Other3706.24106.8
    Smoking status.61
        Smoker16327.417228.7
        Nonsmoker43372.642871.3
    Health maintenance visit in past year.16
        Yes32955.230748.8
        No26744.829351.2
    Charlson comorbidity score<.0001
        024941.817529.2
        112921.714624.3
        212020.115626.0
    >39816.412320.5
    Chronic illnesses<.0001
        0–421435.912721.2
        5–723339.123539.2
    > 814925.023839.6
    Medications prescribed<.0001
        0–527245.611018.3
        6–818230.515325.5
    > 914223.833756.2
    Health care visits in past year<.0001
        0–421335.715025.0
        5–718531.018530.8
    > 819833.226544.2
    Papanicolaou smear in past year*.33
        Yes14857.615161.9
        No10942.49338.1
    Mammogram in past year*.13
        Yes33775.932571.4
        No10724.113028.6
    Fecal occult blood test in past year*<.0001
        Yes10922.118035.9
        No38477.932164.1
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    Table 2.

    Results of Multivariate Analyses on Intervention Effects

    Screening TestNumberOdds Ratio95% CIPValue
    CI = confidence interval.
    Papanicolaou smears1,0571.570.92–2.64.096
    Mammograms1,8321.621.07–9.78.023
    Fecal occult blood test1,9892.561.65–4.01<.0001

Additional Files

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    Files in this Data Supplement:

    • Supplemental data: Appendix 1 - PDF file, 3 pages, 1.33 MB
    • Supplemental data: Appendix 2 - PDF file, 3 pages, 2.07 MB
    • Supplemental data: Appendix 3 - PDF file, 3 pages, 1.30 MB
  • The Article in Brief

    Racial and ethnic minorities, low-income persons, and those who are uninsured or insured by Medicaid are more likely to have poor cancer outcomes. This may be due, in part, to lower use of screening tests. The "Cancer Screening Office Systems" program--a low-cost, non-computerized program--increased the use of screening tests in primary care practices serving these groups. The program focused on 3 cancer-screening tests: mammograms, Pap smears, and fecal occult blood tests (a test for digestive system problems including colon cancer). As part of the program, patients completed a checklist about when they last received cancer-screening tests. The medical office used a series of stickers on medical records to show whether cancer-screening tests were due, ordered, or completed. In addition, office staff members were assigned specific roles in carrying out the program.

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    The Annals of Family Medicine: 2 (4)
    The Annals of Family Medicine
    Vol. 2, Issue 4
    1 Jul 2004
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    A Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers
    Richard G. Roetzheim, Lisa K. Christman, Paul B. Jacobsen, Alan B. Cantor, Jennifer Schroeder, Rania Abdulla, Seft Hunter, Thomas N. Chirikos, Jeffrey P. Krischer
    The Annals of Family Medicine Jul 2004, 2 (4) 294-300; DOI: 10.1370/afm.101

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    A Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers
    Richard G. Roetzheim, Lisa K. Christman, Paul B. Jacobsen, Alan B. Cantor, Jennifer Schroeder, Rania Abdulla, Seft Hunter, Thomas N. Chirikos, Jeffrey P. Krischer
    The Annals of Family Medicine Jul 2004, 2 (4) 294-300; DOI: 10.1370/afm.101
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    • Program to Improve Colorectal Cancer Screening in a Low-Income, Racially Diverse Population: A Randomized Controlled Trial
    • Principles of the Patient-Centered Medical Home and Preventive Services Delivery
    • Costs and Cost Effectiveness of a Health Care Provider-Directed Intervention to Promote Colorectal Cancer Screening
    • Improving Performance in Prevention
    • Costs and Cost-Effectiveness of a Low-Intensity Patient-Directed Intervention to Promote Colorectal Cancer Screening
    • Translation of an Efficacious Cancer-Screening Intervention to Women Enrolled in a Medicaid Managed Care Organization
    • Long-term Results From a Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers
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