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Post 1 Leanneinstructionsreply To The Following Peer Post Based On

Reply to the following peer post based on the following questions. Colorectal Cancer Screening 1. Does insurance/cost of tests come into your decision making? Why or why not? 2. What about patient reliability? Topic 1: Colorectal Cancer Screening In this scenario, the patient is a 47-year-old man who is “fairly healthy” and last seen by a doctor five years prior. He does not take any medications, exercises twice a week at the gym, and has a BMI of 30. During his physical, the topic of colorectal cancer screening was discussed. The purpose of this discussion is to review the general recommendations for colorectal cancer screening, what would be recommended for this patient, and what the screening options would be.

Colorectal cancer (CRC) is the fourth leading cause of death in the United States, although it is highly preventable or treatable if diagnosed early (Valery et al., 2020). The United States Preventive Services Task Force (USPSTF) recommends colorectal cancer screening for all adults between ages 50-75 years (USPSTF, 2016). However, the incidence of CRC in people under 50 is increasing, with 10% to 11% of CRC cases occurring in this younger population and an increase of 1.6% noted each year from 2009 to 2013 (Gupta et al., 2018).

Based on current guidelines, screening is generally recommended starting at age 50 for average-risk individuals, but recent evidence suggests initiating at age 45 for those at slightly higher risk or with specific risk factors, such as family history (American Cancer Society, 2018). In this patient's case, with a family history of colon cancer and risk factors like obesity and male gender, earlier screening is justified. I would recommend that he begin screening before age 50, likely with less invasive options to encourage compliance.

Available screening methods include fecal immunochemical test (FIT), guaiac-based fecal occult blood test (gFOBT), stool DNA testing, colonoscopy, CT colonography, and flexible sigmoidoscopy (American Cancer Society, 2020). In the case of this patient, I would recommend weighing the options with him. The FIT test might be most suitable initially due to its sensitivity, convenience, and non-invasiveness, as it can be performed at home, which enhances patient adherence. Additionally, colonoscopy can be recommended for follow-up if the FIT results are positive or if the patient prefers a more definitive diagnostic approach.

Addressing your questions: insurance and test costs are crucial considerations when recommending screening, especially since some options like colonoscopy can be expensive and may not be fully covered without insurance, potentially impacting patient compliance. Patient reliability is also essential; ensuring the patient understands the importance of screening and follow-up enhances adherence, especially if the test is non-invasive and convenient.

Overall, early screening tailored to individual risk factors improves the chance of detecting CRC at an early stage, ultimately reducing mortality. Education on the importance of screening and addressing barriers like cost and reliability are essential components of effective patient care.

Sample Paper For Above instruction

Understanding the Impact of Insurance, Cost, and Patient Reliability on Colorectal Cancer Screening Decisions

Colorectal cancer (CRC) remains a significant health concern as the fourth leading cause of cancer-related death in the United States (Valery et al., 2020). Early detection through screening significantly improves prognosis and survival rates. Therefore, understanding the variables that influence screening decisions, such as insurance coverage, test costs, and patient reliability, is essential for healthcare providers aiming to enhance screening rates and outcomes.

Insurance and Cost Considerations in CRC Screening

The financial aspect of cancer screening plays a pivotal role in patient compliance. Colonoscopy, the gold standard for CRC screening, often incurs high direct costs, which may not be fully covered by insurance plans (Zafar et al., 2013). Consequently, patients without adequate insurance or facing high out-of-pocket expenses may delay or refuse screening, risking late-stage diagnosis. Conversely, less invasive and lower-cost options like stool-based tests (FIT, gFOBT, stool DNA tests) tend to be more accessible. The Affordable Care Act and USPSTF recommendations have increased insurance coverage for preventive services, including CRC screening with no cost-sharing in many cases (Sabatino et al., 2012). Nonetheless, disparities in coverage and affordability still exist, influencing screening behaviors.

Patient Reliability and Adherence to Screening

Patient reliability, encompassing understanding, motivation, and trust in the healthcare system, directly impacts adherence to screening recommendations. A patient’s likelihood of completing scheduled tests, follow-up appointments, and lifestyle adjustments depends significantly on health literacy, cultural beliefs, and perceived benefits versus barriers (Klabunde et al., 2015). For example, a patient who perceives a stool test as inconvenient or doubts its effectiveness may decline screening, especially if logistical barriers are present. Effective communication, education, and personalized counseling are crucial strategies to improve reliability and adherence, particularly among populations with historically lower screening rates.

Implications for Practice

Healthcare providers must adopt a holistic approach by addressing financial barriers, providing clear information about the importance of early detection, and selecting suitable screening options aligned with patient preferences and risk factors. For instance, for patients concerned about costs or invasive procedures, stool-based tests offer a viable alternative. Ensuring follow-up and reminders can reinforce reliability. Tailoring recommendations based on individual circumstances maximizes participation and early detection efforts (Hingorani et al., 2019).

Conclusion

In conclusion, insurance coverage, test costs, and patient reliability significantly influence colorectal cancer screening rates and outcomes. Addressing these factors through policy, education, and patient-centered approaches enhances early detection and reduces mortality from this preventable disease.

References

• Hingorani, S., et al. (2019). Strategies to Improve Screening Uptake in Colorectal Cancer. Journal of Clinical Oncology, 37(37), 3454-3462.
• Klabunde, C.N., et al. (2015). Improving colorectal cancer screening in the United States. Cancer, 121, 1023-1028.
• Sabatino, S.A., et al. (2012). Impact of insurance coverage on colorectal cancer screening. Cancer Epidemiology, Biomarkers & Prevention, 21(4), 598-607.
• Zafar, S., et al. (2013). Out-of-pocket costs and adherence to screening. Journal of the National Cancer Institute, 105(23), 1792-1796.

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References

• American Cancer Society. (2018). Guideline for colorectal cancer screening. Retrieved from https://www.cancer.org
• American Cancer Society. (2020). Colorectal cancer facts & figures. Retrieved from https://www.cancer.org
• Gupta, S., et al. (2018). Early-Onset Colorectal Cancer: Epidemiology and Risk Factors. Gastroenterology, 154(6), 1765-1777.
• Macrae, F. (2020). Epidemiology, Risk Factors, and Protective Factors in Colorectal Cancer. Journal of Clinical Oncology.
• Sullivan, J., et al. (2021). Impact of Socioeconomic Factors on CRC Screening. Public Health Reports, 136(1), 97-105.
• Valery, J. R., et al. (2020). Gender-based differences in adherence to CRC screening. Journal of Primary Care & Community Health, 11.
• United States Preventive Services Task Force. (2016). Screening for colorectal cancer. JAMA, 315(23), 2564-2575.
• Zafar, S., et al. (2013). Costs and adherence in CRC screening. JNCI, 105(23), 1792-1796.