Computer-assisted flagging of individuals at high risk of colorectal cancer in a large health maintenance organization using the colonflag

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Authors:

Ran Goshen

Eran N. Choman

Ayelet Ran

Efrat Muller

Revital Kariv

Gabriel Chodick

Nachman Ash

Steven Narod

Varda Shalev

Title

Computer-assisted flagging of individuals at high risk of colorectal cancer in a large health maintenance organization using the colonflag

Purpose

To evaluate in a sample of adults who had been noncompliant with colorectal cancer
(CRC) screening whether screening could be enhanced by an automated patient recall system
based on identifying high-risk individuals using the ColonFlag test and an electronic medical
record database.

Methods

A total of 79,671 individuals who were determined to be non-compliant with current
screening recommendations were identified in the Maccabi Health Services program in Israel.
Their cancer risk was determined by ColonFlag using information on age, sex, and CBC results.
Doctors of individuals who were flagged as high risk were notified and asked to follow up with
their patients.

Results

The ColonFlag identified 688 men and women who scored in the highest 0.87 percentile.
Of these individuals, 254 had colonoscopies performed by Maccabi physicians, and 19 CRCs
(7.5%) were found. An additional 15 cancers primarily identified outside of Maccabi were found
through code matching.

Conclusions

The ColonFlag test is a rapid, efficient, and inexpensive test that can be applied to
scan electronic medical records to identify individuals at high risk of CRC who would otherwise
avoid screening.