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A series of detailing sessions to small urban physician practices about colorectal cancer (CRC) screening improved the practices' screening rates by 7 percent, but not cost-effectively, according to a study published online Oct. 13 in the Journal of Clinical Oncology.

Veena Shankaran, M.D., of the Veterans Affairs Chicago Healthcare System, and colleagues randomized physician practices in New York City to receive four sessions of academic detailing on CRC screening and barriers to utilization plus supporting printed material and educational CD-ROMs, or no CRC detailing. The researchers compared CRC screening rates at the practices at baseline and 12 months, and calculated the cost of the intervention and the incremental cost-effectiveness ratio.

Over the study period, the researchers found that the CRC screening detailing resulted in a 7 percent increase in colonoscopy screening at the targeted physician practices compared to the control group. However, the cost of the improvement was calculated at $21,124 per percentage point increase. Adjusting the cost for physician practice size, the cost per percentage point increase ranged from $13,631 to $36,109.

"A comprehensive, multicomponent academic detailing intervention conducted in small practices in metropolitan New York was clinically effective in improving CRC screening rates, but was not cost-effective" the authors write.

Source: Journal of Clinical Oncology

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