Mapping colorectal cancer screening workflows in primary care.

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Colorectal cancer (CRC) screening is crucial for early detection and prevention, yet uptake remains suboptimal.
• Primary care settings are vital for CRC screening but frequently miss targets.
• High CRC mortality persists due to low screening adherence.

Purpose of the Study:

• To map and analyze CRC screening workflows in primary care.
• To identify variations in screening processes across different clinic types.
• To understand how workflows impact screening rates for average-risk patients.

Main Methods:

• Eight primary care clinics with varying CRC screening rates were studied.
• Interviews with clinicians and staff detailed their CRC screening workflows.
• Workflow maps were collaboratively developed and analyzed for similarities and differences.

Main Results:

• CRC screening rates varied significantly (54.5%–90%) across clinics.
• Commonalities existed in patient identification, communication, test offerings, and results reporting.
• High-screening clinics emphasized communication, clinical integration, and follow-up for missing results.

Conclusions:

• CRC screening workflows share common stages but differ in execution.
• Strategies like patient decision tools, improved communication, navigation, and results tracking can boost screening uptake.
• Optimizing primary care workflows is essential for increasing CRC screening adherence.