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Published on: June 8, 2020
Computer-Assisted Flagging of Individuals at High Risk of Colorectal Cancer in a Large Health Maintenance
Ran Goshen1, Eran Choman1, Ayelet Ran1
1Ran Goshen, Eran Choman, Ayelet Ran, and Efrat Muller, Medial EarlySign, Kfar Malal; Revital Kariv, Gabriel Chodick, and Varda Shalev; Maccabi Institute for Research and Innovation, Maccabi Healthcare Services; Nachman Ash, Maccabi Healthcare Services, Tel-Aviv; Revital Kariv, Gabriel Chodick, and Varda Shalev, Tel Aviv University; Revital Kariv, Sourasky Medical Center; Nachman Ash, Ariel University, Ariel, Israel; and Steven Narod, Women's College Research Institute, Women's College Hospital, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
An automated system using ColonFlag identified high-risk individuals for colorectal cancer (CRC) who avoid screening. This approach successfully detected numerous CRCs among noncompliant patients, enhancing early cancer detection.
Area of Science:
- Oncology
- Preventive Medicine
- Health Informatics
Background:
- Colorectal cancer (CRC) screening noncompliance remains a significant public health challenge.
- Identifying high-risk individuals who avoid screening is crucial for improving early detection rates.
Purpose of the Study:
- To assess the efficacy of an automated patient recall system for colorectal cancer (CRC) screening.
- To evaluate the ColonFlag test combined with electronic medical records for identifying high-risk, noncompliant individuals.
Main Methods:
- Utilized ColonFlag and electronic medical records to identify 79,671 noncompliant individuals for CRC screening.
- Assessed cancer risk based on age, sex, and complete blood count (CBC) results.
- Physician notification and follow-up were implemented for high-risk flagged individuals.
Main Results:
- ColonFlag identified 688 individuals in the highest 0.87 percentile for CRC risk.
- Colonoscopies were performed on 254 individuals, leading to the detection of 19 CRCs (7.5%).
- An additional 15 cancers were identified through code matching.
Conclusions:
- ColonFlag is a rapid, efficient, and cost-effective tool for electronic health record-based screening.
- The system effectively identifies high-risk individuals who might otherwise miss screening opportunities.
- Automated recall systems leveraging risk stratification can enhance CRC screening participation and detection.
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