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Rate of Ordering Cancer Screening Tests Decreases During Clinic Day

FRIDAY, May 10, 2019 -- As the clinic day progresses, the rate of clinician ordering of breast and colorectal cancer screening tests decreases, according to a study published online May 10 in JAMA Network Open.

In a retrospective quality improvement study of 33 primary care practices, Esther Y. Hsiang, from Johns Hopkins University in Baltimore, and colleagues examined the correlations between primary care clinic appointment time and clinician ordering and patient completion of breast and colorectal cancer screening.

The researchers found that among the 19,254 patients eligible for breast cancer screening, the screening test order rates were 63.7 percent at 8 a.m., declined to 48.7 percent at 11 a.m., increased to 56.2 percent at 12 p.m., and then declined to 47.8 percent at 5 p.m. (adjusted odds ratio for overall trend, 0.94). Trends in screening test completion decreased from 33.2 to 17.8 percent from 8 a.m. to 5 p.m. (adjusted odds ratio, 0.95). Among the 33,468 patients eligible for colon cancer screening, test order rates were 36.5 percent at 8 a.m., 31.3 percent at 11 a.m., 34.4 percent at 12 p.m., and 23.4 percent at 5 p.m. (adjusted odds ratio, 0.94). Trends in screening test completion rates decreased from 28.0 to 17.8 percent from 8 a.m. to 5 p.m. (adjusted odds ratio, 0.97).

"Future interventions targeting improvements in cancer screening should consider how time of day influences these behaviors," the authors write.

One author disclosed financial ties to health care industries.

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Posted: May 2019

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