Develop a Primary Care Colon Cancer Screening Consortium

描述(由申请人提供) 结肠癌筛查的应用没有跟上支持其价值的证据的步伐。这项R-21提案将为通过结肠镜检查长期、持续地探索结肠癌筛查实践奠定基础，为基于人群的结肠镜检查登记建立基础设施，并开始招募患者。该登记是以新汉普郡乳房X光摄影网络为基础的基于人口的乳房X光检查登记系统建立的，该网络是全国乳房X光检查联盟的一部分。在新汉普郡这项工作的基础上，我们将开始发展一个初级保健结肠癌筛查联盟。该联盟将在新罕布夏州和纽约市的实践研究网络之间建立初步联系，作为提高初级保健中结肠癌筛查知识和质量的长期努力的一部分，重点是解决结肠癌筛查中的卫生保健差距。这项建议的具体目标是： 1.在新罕布夏州建立以人口为基础的结肠镜检查登记所需的基础设施和程序； 2.登记通过达特茅斯希区柯克医疗中心及其12个初级保健实践接受结肠镜检查的初始患者； 3.评估扩大登记范围以包括对新罕布夏州居民进行的所有结肠镜检查的可行性和试点试验； 4.探讨在纽约市建立以人群为基础的结肠镜检查登记处的可行性，并采取初步步骤，重点是通过社区卫生中心接受初级保健服务不足的人群。这将为创建初级保健结肠癌筛查联盟提供初步步骤。总部设在达特茅斯的研究团队为这一开发项目带来了在初级保健、国家癌症研究所赞助的多地点临床试验方面的多年研究经验，以及NH乳房摄影网络的经验。该项目得到了诺里斯·科顿癌症中心的资金支持，得到了新罕布夏州州长癌症和慢性病咨询委员会的支持，并得到了全州初级保健临床医生和结肠镜医生的承诺。该财团合作伙伴与达特茅斯团队建立了良好的关系，为这一努力带来了实质性的耐心、种族和经济多样性。

DESCRIPTION (provided by applicant) Application of colon cancer screening has not kept pace with evidence supporting its value. This R-21 proposal will set the stage for long term, ongoing exploration of colon cancer screening practices through colonoscopy by creating the infrastructure for a population-based colonoscopy registry and beginning to enroll patients. The registry is modeled on population-based mammography registry based in the New Hampshire Mammography Network, which is part of a national mammography consortium. Building on this work in New Hampshire, we will begin to develop a primary care colon cancer screening consortium. The consortium will create initial linkages between practice-based research networks in New Hampshire and New York City as part of a long term effort to enhance knowledge and quality of colon cancer screening in primary care with an emphasis on addressing health care disparities in colon cancer screening. Specific aims of this proposal are: 1. To develop the infrastructure and procedures needed for a population-based colonoscopy registry in New Hampshire; 2. To enroll in the registry initial patients receiving colonoscopy through Dartmouth Hitchcock Medical Center and its 12 primary care practices; 3. To assess the feasibility and pilot test expanding the registry to include all colonoscopies performed on New Hampshire residents; 4. To explore the feasibility of and take initial steps towards developing a population-based colonoscopy registry in New York City focused on under served populations receiving primary care through community health centers. This will provide initial steps to create a primary care colon cancer screening consortium. The Dartmouth-based research team brings years of experience with research in primary care, multi-site National Cancer Institute-sponsored clinical trials, and experience with the NH Mammography Network to this developmental project. The project is backed by the resources of Norris Cotton Cancer Center, the endorsement of the New Hampshire Governors Advisory Council on Cancer and Chronic Disease, and by the commitment of primary care clinicians and colonoscopists state-wide. The consortium partner has well-established relationships with the Dartmouth team bringing substantial patient racial and economic diversity to the effort.