ArticleBMJ open quality2019
Offering patients a choice for colorectal cancer screening: a quality improvement pilot study in a quality circle of primary care physicians.
Article in BMJ open quality, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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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.
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Who cites it
7 citing papers in PubMed.
- Optimizing colorectal cancer screening through quality circles of primary care physicians: a cluster randomized controlled trial.International journal of public health · 2026Trial
- Promoting shared decision-making in colorectal cancer screening in primary care: A cluster randomized controlled trial.PloS one · 2026Trial
- Breast cancer screening best practices: a Canadian multidisciplinary consensus-based approach for primary care providers.BMJ open · 2026Article
- Organized Colorectal Cancer Screening Programs in Switzerland - Quo Vadis?International journal of public health · 2025Article
- Association between the colorectal cancer screening status of primary care physicians and their patients: Evidence from the Swiss Sentinella practice-based research network.Preventive medicine reports · 2023Article
- Undertaking general practice quality improvement to improve cancer screening - a thematic analysis of provider experiences.BMC family practice · 2021Article
- Implementation of a stereotactic body radiotherapy program for unresectable pancreatic cancer in an integrated community academic radiation oncology satellite network.Clinical and translational radiation oncology · 2021Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGuidelines recommend primary care physicians (PCPs) offer patients a choice between colonoscopy and faecal immunochemical test (FIT) for colorectal cancer (CRC) screening. Patients choose almost evenly between both tests but in Switzerland, most are tested with colonoscopy while screening rates are low. A quality circle (QC) of PCPs is an ideal site to train physicians in shared decision-making (SDM) that will help more patients decide if they want to be tested and choose the test they prefer.
objectiveSystematically assess CRC screening status of eligible 50-75 y.o. patients and through SDM increase the proportion of patients who have the opportunity to choose CRC screening and the test (FIT or colonoscopy).
methodsWorking through four Plan-Do-Study-Act (PDSA) cycles in their QC, PCPs adapted tools for SDM and surmounted organisational barriers by involving practice assistants. Each PCP included 20, then 40 consecutive 50-75 y.o. patients, repeatedly reported CRC status as well as the proportion of eligible patients with whom CRC screening could be discussed and patients' decisions.
results9 PCPs initially included 176, then 320 patients. CRC screening status was routinely noted in the electronic medical record and CRC screening was implemented in daily routine, increasing eligible patients' chance to be offered screening. Over a year, screening rates trended upwards, from 37% to 40% (p=0.46) and FIT use increased (2%-7%, p=0.008). Initially, 7/9 PCPs had no patient ever tested with FIT; after the intervention, only 2/8 recorded no FIT tests.
conclusionsThrough data-driven PDSA cycles and significant organisational changes, PCPs of a QC systematically collected data on CRC screening status and implemented SDM tools in their daily routine. This increased patients' chance to discuss CRC screening. The more balanced use of FIT and colonoscopy suggests that patients' values and preferences were better respected.
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