Patient completion of screening tests
Percentage of eligible patients who received screening for diabetes, cardiovascular disease risk (lipids), colorectal cancer, cervical cancer, or breast cancer (see data definition).
What do you see?
- Are there geographic differences in screening rates? For example, are there differences in screening rates in rural areas compared to urban?
- What are some of the reasons that patients may not get the recommended screening?
- Are there any differences in completion rates for the various screening tests? What are some factors that could account for this?
Whether you’re a patient, provider, or health system administrator, thinking about why these differences might exist can start conversations and lead to solutions for improved quality of healthcare.
*Data courtesy of Alberta Health Services and Alberta Health
Understanding patient completion of screening tests
Doctors order screening tests to help with early detection of diseases in patients who they know are at risk of that disease, either because of family history or other factors such as age, gender or lifestyle. Established guidelines for screening can be found from the Alberta Screening and Prevention program. Early detection of disease is important because early treatment can reduce long term complications and improve outcomes and overall quality of care for patients.
Screening rates are an important measure of quality of care. The percentage of eligible Albertans (i.e., those most likely to benefit from the test) who receive screening tests is affected by the actions of both doctors and patients. Doctors must offer screening to their patients, and patients must follow-through by going to the lab (e.g., for diabetes and lipid screening) or making and attending an appointment for certain types of tests (e.g., mammogram for breast cancer screening or colonoscopy for colorectal cancer screening).
Considerations when reviewing the results
- The information shows the percentage of patients who completed a screening test, not how many were offered a screening test.
- There are many factors that affect the rate of completed screening tests. This includes how often doctors offer the screening tests, patient acceptability and willingness to follow-through with a screening test, and availability of certain screening tests in some areas of the province.
Information about diabetes screening
Diabetes screening is done using a blood test. The current guidelines used in Alberta for diabetes screening are available here: https://actt.albertadoctors.org/file/asap-maneuvers-menu.pdf
Information about lipid testing for cardiovascular disease
Screening for diseases that are related to abnormal lipids is done using a blood test that measures the levels of different kinds of lipids (fats) in the patient’s blood. This test is used with other information about the patient such as age, gender, blood pressure, smoking status, and family history to determine the patient’s level of risk for heart disease and stroke. The current guidelines used in Alberta for lipid screening are available here: https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/CVD-Risk-CPG.pdf
Information about colorectal cancer screening
The FIT (Fecal Immunochemical Test) is the recommended method of colorectal cancer screening for most patients. It is a lab test done on a sample of the patient’s stool. Some patients may be screened using a sigmoidoscopy or colonoscopy which are procedures that allows healthcare providers to look inside the patient’s intestines for disease. The current guidelines used in Alberta for colorectal cancer screening are available here: https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/colorectal-cancer-screening-guideline.pdf
Information about cervical cancer screening
Cervical cancer screening is done using a Papanicolaou (Pap) test, which checks to see if a woman’s cervix is healthy. The current cervical cancer screening guidelines used in Alberta are available here: https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/Cervical-Cancer-Screening-CPG.pdf
Information about breast cancer screening (mammogram)
Breast cancer screening is done using a mammogram. The current guidelines used in Alberta for mammograms are available here: https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/Breast-Cancer-Screening-CPG.pdf
The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. The information in this chart can be used as input to think and have conversations about primary healthcare in Alberta using the lens of the dimensions of quality shown on the right:
Dimensions of Quality