Evidence map›Paper›PMID 26526080›Full record

Trial reportThe American journal of gastroenterology2016

Adherence to Competing Strategies for Colorectal Cancer Screening Over 3 Years.

Peter S Liang, Chelle L Wheat, Anshu Abhat, Alison T Brenner, Angela Fagerlin, Rodney A Hayward, Jennifer P Thomas, Sandeep Vijan, John M Inadomi

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 5 pooled it
3.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 5 syntheses or guidelines pooled it, 114 citations in OpenAlex.

  1. Guideline
  2. A Systematic Review of Repeat Fecal Occult Blood Tests for Colorectal Cancer Screening.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020
    Pooled it
  3. Pooled it
  4. Guideline
  5. Pooled it
  6. A Randomized Trial of Choice Architecture and Mailed Colorectal Cancer Screening Outreach in a Community Health Setting.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024
    Trial
  7. Trial
  8. Trial
  9. Trial
  10. Repeat Annual Colorectal Cancer Screening in Rural Community Clinics: A Randomized Clinical Trial to Evaluate Outreach Strategies to Sustain Screening.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2020
    Trial
  11. Trial
  12. Trial
  13. The Efficacy of Direct Mail, Patient Navigation, and Incentives for Increasing Mammography and Colonoscopy in the Medicaid Population: A Randomized Controlled Trial.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2018
    Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Article
  19. Article
  20. Colorectal cancer screening barriers, facilitators, and promotion recommendations by Alaska Native people who are non-adherent to colorectal cancer screening.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025
    Article

4 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Peter S LiangDepartment of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington, USA.
Chelle L WheatDepartment of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA.
Anshu AbhatDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Alison T BrennerCecil Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Angela FagerlinVeteran Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA.
Rodney A HaywardVeteran Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA.
Jennifer P ThomasDepartment of Medicine, University of California, San Francisco, California, USA.
Sandeep VijanVeteran Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA.
John M InadomiDepartment of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington, USA.
University of Washington · USVA Center for Clinical Management Research · USUniversity of California, San Francisco · USUniversity of Michigan–Ann Arbor · USUniversity of North Carolina at Chapel Hill · US

Funding

UNIVERSITY OF WASHINGTON GI TRAINING GRANTT32DK007742 · NIDDK · UNIVERSITY OF WASHINGTON · PI GRADY, WILLIAM MALLORY · 1996 to 2022
$4.7M
Improving Gastrointestinal Disease Outcomes in Vulnerable PopulationsK24DK080941 · NIDDK · UNIVERSITY OF WASHINGTON · PI INADOMI, JOHN MATTHEW · 2008 to 2019
$1.8M
Adherence and the Economics of Colon Cancer ScreeningR01CA106773 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI YEE, HAL F · 2006 to 2009
$1.4M
NCI NIH HHS R01 CA106773NCI NIH HHS R01CA106773NIDDK NIH HHS K24 DK080941NIDDK NIH HHS K24DK080941NIDDK NIH HHS T32 DK007742NIDDK NIH HHS T32DK007742
6 · The paper itself

Abstract

objectivesWe have shown that, in a randomized trial comparing adherence to different colorectal cancer (CRC) screening strategies, participants assigned to either fecal occult blood testing (FOBT) or given a choice between FOBT and colonoscopy had significantly higher adherence than those assigned to colonoscopy during the first year. However, how adherence to screening changes over time is unknown.

methodsIn this trial, 997 participants were cluster randomized to one of the three screening strategies: (i) FOBT, (ii) colonoscopy, or (iii) a choice between FOBT and colonoscopy. Research assistants helped participants to complete testing only in the first year. Adherence to screening was defined as completion of three FOBT cards in each of 3 years after enrollment or completion of colonoscopy within the first year of enrollment. The primary outcome was adherence to assigned strategy over 3 years. Additional outcomes included identification of sociodemographic factors associated with adherence.

resultsParticipants assigned to annual FOBT completed screening at a significantly lower rate over 3 years (14%) than those assigned to colonoscopy (38%, P<0.001) or choice (42%, P<0.001); however, completion of any screening test fell precipitously, indicating the strong effect of patient navigation. In multivariable logistic regression analysis, being randomized to the choice or colonoscopy group, Chinese language, homosexuality, being married/partnered, and having a non-nurse practitioner primary care provider were independently associated with greater adherence to screening (P<0.01).

conclusionsIn a 3-year follow-up of a randomized trial comparing competing CRC screening strategies, participants offered a choice between FOBT and colonoscopy continued to have relatively high adherence, whereas adherence in the FOBT group fell significantly below that of the choice and colonoscopy groups. Patient navigation is crucial to achieving adherence to CRC screening, and FOBT is especially vulnerable because of the need for annual testing.

Indexed as

ColonoscopyOccult BloodAgedColorectal NeoplasmsEarly Detection of CancerFemaleHumansMaleMiddle AgedPatient ComplianceTime Factors

Identifiers

PMID26526080
PMCPMC4887132
OpenAlexW2181675086

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.