Cluster randomized trial of multilevel primary care intervention to improve follow-up of overdue abnormal cancer screening test results

Realizing the benefits of cancer screening requires testing of eligible individuals and processes to ensure follow-up of abnormal results. A cluster randomized randomized trial at 44 primary care practices investigated interventions to improve timely follow-up of abnormal breast, cervical, colorectal, and lung cancer screening results. Among 11,980 patients with at least one abnormal cancer screening test result not yet followed up, completion of follow-up within 120 days of study enrollment was higher among patients exposed to electronic health record (EHR) reminders, outreach, and navigation (31.4%) or EHR reminders and outreach (31.0%) than those exposed to EHR reminders only (22.7%) or usual care (22.9%). The authors conclude that systems-based outreach in primary care setting can improve the timely follow-up of abnormal cancer screening results, but gaps in follow-up care need to be addressed if the full benefits of preventive cancer screening are to be realized.