Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA 98101. Email:
Am J Manag Care. 2019 Apr;25(4):174-180.
Fecal immunochemical tests (FITs) can efficiently screen for colorectal cancer (CRC), but little is known on the timing to their completion. We investigate the time to return of a FIT following an order and describe patient characteristics associated with FIT return.
Retrospective cohort study.
We identified 63,478 members of Kaiser Permanente Washington, aged 50 to 74 years, who received a FIT order from 2011 through 2012. Patient characteristics were ascertained through administrative and electronic health record data sources. We compared time from FIT order to return by patient characteristics using Kaplan-Meier and Cox regression methods.
About half (53.7%) of members completed a FIT. Median time from order to return was 13 days (mean, 44.5 days; interquartile range, 6-42 days). There was higher completion of FITs among Asian patients (hazard ratio [HR], 1.43; 95% CI, 1.38-1.48), black patients (HR, 1.13; 95% CI, 1.08-1.19), and Hispanic patients (HR, 1.10; 95% CI, 1.04-1.16) compared with white patients; among patients with recent CRC testing (vs no testing in past 2 years; HR, 1.90; 95% CI, 1.86-1.95); and among patients with Medicare insurance (vs commercial; HR, 1.30; 95% CI, 1.24-1.37). Factors associated with decreased FIT completion included younger age (50-54 years vs 70-74 years; HR, 0.87; 95% CI, 0.82-0.92), obesity (vs normal body mass index; HR, 0.88; 95% CI, 0.86-0.91), and higher Charlson Comorbidity Index score (≥3 vs 0; HR, 0.82; 95% CI, 0.79-0.87).
Time to return of FIT varies by patient characteristics. We observed greater FIT completion among people of color, suggesting that racial disparities in CRC may not be due to patient completion of the test after an order is received.
粪便免疫化学检测（FIT）可有效地筛查结直肠癌（CRC），但对于完成检测所需的时间知之甚少。本研究旨在探讨 FIT 检测完成的时间，并描述与 FIT 检测回报相关的患者特征。
回顾性队列研究。
我们纳入了 Kaiser Permanente Washington 的 63478 名年龄在 50 至 74 岁之间的成员，这些成员在 2011 年至 2012 年期间接受了 FIT 检测。通过行政和电子健康记录数据源确定患者特征。我们通过 Kaplan-Meier 和 Cox 回归方法比较了不同患者特征下从 FIT 检测订单到回报的时间。
约有一半（53.7%）的成员完成了 FIT 检测。从订单到回报的中位时间为 13 天（平均 44.5 天；四分位间距为 6-42 天）。与白人患者相比，亚洲患者（HR，1.43；95%CI，1.38-1.48）、黑人患者（HR，1.13；95%CI，1.08-1.19）和西班牙裔患者（HR，1.10；95%CI，1.04-1.16）完成 FIT 检测的比例更高；与过去 2 年内未进行 CRC 检测的患者相比（HR，1.90；95%CI，1.86-1.95）；与拥有医疗保险的患者相比（HR，1.30；95%CI，1.24-1.37）。与 FIT 检测完成率降低相关的因素包括年龄较小（50-54 岁 vs 70-74 岁；HR，0.87；95%CI，0.82-0.92）、肥胖（HR，0.88；95%CI，0.86-0.91）和较高的 Charlson 合并症指数评分（≥3 分 vs 0 分；HR，0.82；95%CI，0.79-0.87）。
FIT 检测完成的时间因患者特征而异。我们观察到有色人种的 FIT 检测完成率更高，这表明 CRC 中的种族差异可能不是由于患者在收到检测订单后完成了检测。
