Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky

Mark Dignan, Brent Shelton, Stacey A. Slone, Cheri Tolle, Sohail Mohammad, Nancy Schoenberg, Kevin Pearce, Emily Van Meter, Gretchen Ely

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Objective: This report describes findings from a randomized controlled trial of an intervention to increase colorectal cancer (CRC) screening in primary care practices in Appalachian Kentucky. Methods: Sixty-six primary care practices were randomized to early or delayed intervention groups. The intervention was provided at practices using academic detailing, a method of education where providers receive information on a specific topic through personal contact. Data were collected in cross-sectional surveys of medical records at baseline and six months post-intervention. Results: A total of 3844 medical records were reviewed at baseline and 3751 at the six-month follow-up. At baselines, colonoscopy was recommended more frequently (43.4%) than any other screening modality, followed by fecal occult blood testing (18.0%), flexible sigmoidoscopy (0.4%), and double-contrast barium enema (0.3%). Rates of documented screening results were higher for all practices at the six-month follow-up for colonoscopy (31.8% vs 29.6%) and fecal occult blood testing (12.2% vs 11.2%). For early intervention practices that recommended screening, colonoscopy rates increased by 15.7% at six months compared to an increase of 2.4% in the delayed intervention practices (p. =.01). Conclusions: Using academic detailing to reach rural primary care providers with a CRC screening intervention was associated with an increase in colonoscopy.

Original languageEnglish
Pages (from-to)70-74
Number of pages5
JournalPreventive Medicine
Issue number1
StatePublished - Jan 2014

Bibliographical note

Funding Information:
This research was supported by the National Cancer Institute at the National Institutes of Health ( R01 CA113932 ). The project was initiated and analyzed by the investigators.


  • Appalachia
  • Colorectal cancer screening
  • Primary care
  • Randomized controlled trial

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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