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      Research Area: Saving Lives through Cancer Screening and Prevention

      According to the CDC, cancer is one of the top three leading causes of death in the U.S. Screening and early detection can offer hope for better outcomes and earlier intervention. AMGA works with members to help identify screening gaps, new performance quality measures to ensure timely screening follow-ups, and adherence to treatment. With these insights, AMGA members can proactively intervene and ensure timely follow-up with patients to support value-based care.

      Colorectal cancer (CRC) screening and prevention

      • Colorectal Cancer Screening Follow-Up Measure Development: Patients and health systems are increasingly using stool-based tests (SBTs) for convenience and cost and to maximize population-level screening rates. When a SBT is positive, an extra step is required, yet existing HEDIS measures only capture the first step in the screening process. In response, AMGA developed and tested a measure to track the completion of screening for patients with positive SBTs, i.e., rates of follow up after a positive SBT. The measure is further stratified by race and ethnicity to identify disparities in CRC screening and follow-up. Learn More
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      • Timeliness of Follow-Up after At-Home Colorectal Cancer Screening Test: AMGA reviewed electronic health record data to assess follow up colonoscopy rates for CRC after a positive stool-based test (SBT). Qualitative interviews with providers from five healthcare organizations were conducted to contextualize findings and understand barriers and facilitators to follow-up at the patient, provider, and organization levels. Most providers were unaware of low follow-up rates at <50% and of disparities across patient race, insurance type, and number of comorbid conditions. Learn More
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      • COVID-19 Impact Timeliness of Follow-Up after At-Home Colorectal Cancer Screening Test: The COVID-19 pandemic significantly reduced rates of follow up colonoscopy for patients with a positive stool-based test (SBT) for colorectal cancer (CRC). Patients with positive SBTs had much lower rates of follow-up in 2020 relative to 2019, which created a potential backlog of patients at high risk of CRC that never recovered to the same level as other months. View Poster

      • Screening Follow-Up to Improve Colorectal Cancer Treatment after Testing: AMGA conducted preliminary data exploration using EHR and billing data and found that among 38,424 patients with a positive FIT or FIT-DNA, 19%, 33%, 41%, 48%, and 53% had a follow-up colonoscopy within 30, 60, 90, 180, and 365 days, respectively. Across 21 organizations, the proportion with colonoscopy follow-up within 90 days ranged from 27% to 60%, showing suboptimal follow-up for a positive test overall, in addition to wide variation across organizations. Learn More

      • CRC Collaborative: Learn More

      Human papillomavirus (HPV) and cancer prevention

      • Scalable Health System Strategies to Raise HPV Vaccination Rates: This pragmatic NIH trial, led by UCLA, aims to raise HPV vaccine initiation rates in children and adolescents ages 11 to 17. The study will implement and evaluate STOP HPV clinical online communications training alone and in combination with learning Collaboratives to reduce missed HPV vaccine opportunities. The goal is to refine interventions and advance scalable, cost-effective uptake of HPV vaccine initiation in health systems. AMGA is seeking members for the study. Learn More
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      • Optimizing HPV Vaccine Communication and Use of Standing Orders: This NIH trial, led by UNC, will evaluate the impact of HPV Announcement Approach Communications Training (AAT) and leverage the entire primary care team (including RNs and Mas) to support optimization of standing orders. The aim is to increase HPV vaccine initiation in children ages 9 and 10. Four AMGA members have completed the intervention phase. Learn More
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      Prostate cancer

      • Primary Adherence to Oral Anti-Prostate Cancer Medications: AMGA is finalizing a database study to better understand trends in primary adherence to oral anti-prostate cancer medications. Preliminary findings indicate differences in adherence by drug type, insurance type, and prescriber. Interviews with practicing urologic oncologists were completed to contextualize findings highlighted challenges with navigating specialty pharmacies, lack of consistent adherence documentation, and patient follow up after initial prescribing. Complete findings coming soon! 

      Smoking cessation

      • Individual Physician Approaches to Smoking Cessation: AMGA studied smoking cessation rates in 22 healthcare organizations (HCOs) and found that rates varied substantially at the practitioner, practice site, and health system levels. Across 22 HCOs and among 1 million patients, 24% quit smoking. Characteristics associated with quitting included older age, Hispanic ethnicity, being married, urban residence, commercial insurance, pregnancy, and a diagnosis of a serious chronic condition, e.g., pneumonia, asthma. It is likely that individual physician approaches to smoking cessation influence patients' likelihood of quitting. Learn More 

       

       
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