Factors Associated With Clinician Recommendations for Colorectal Cancer Screening Among Average-Risk Patients: Data From a National Survey

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Zhu, Xuan ; Weiser, Emily ; Jacobson, Debra J. ; Griffin, Joan M. ; Limburg, Paul J. ; Finney Rutten, Lila J.
• Description:
  Introduction
  
  Colorectal cancer (CRC) screening among average-risk patients is underused in the US. Clinician recommendation is strongly associated with CRC screening completion. To inform interventions that improve CRC screening uptake among average-risk patients, we examined clinicians’ routine recommendations of 7 guideline-recommended screening methods and factors associated with these recommendations.
  
  Methods
  
  We conducted an online survey in November and December 2019 among a sample of primary care clinicians (PCCs) and gastroenterologists (GIs) from a panel of US clinicians. Clinicians reported whether they routinely recommend each screening method, screening method intervals, and patient age at which they stop recommending screening. We also measured the influence of various factors on screening recommendations.
  
  Results
  
  Nearly all 814 PCCs (99%) and all 159 GIs (100%) reported that they routinely recommend colonoscopy for average-risk patients, followed by stool-based tests (more than two-thirds of PCCs and GIs). Recommendation of other visualization-based methods was less frequent (PCCs, 26%–35%; GIs, 30%–41%). A sizable proportion of clinicians reported guideline-discordant screening intervals and age to stop screening. Guidelines and clinical evidence were most frequently reported as very influential to clinician recommendations. Factors associated with routine recommendation of each screening method included clinician-perceived effectiveness of the method, clinician familiarity with the method, Medicare coverage, clinical capacity, and patient adherence.
  
  Conclusion
  
  Clinician education is needed to improve knowledge, familiarity, and experience with guideline-recommended screening methods with the goal of effectively engaging patients in informed decision making for CRC screening.
  
  
• Subjects:
  Aged Colonoscopy Colorectal Neoplasms Early Detection Of Cancer Humans Mass Screening Medicare Occult Blood
• Source:
  Prev Chronic Dis. 2022; 19
• DOI:
  http://dx.doi.org/10.5888/pcd19.210315
• ISSN:
  1545-1151
• Pubmed ID:
  35420980
• Pubmed Central ID:
  PMC9044901
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Location:
  North America
• Volume:
  19
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:8a91549113c878c4e47378f5ab669181a5d21f3f162549c15ba728b228649a24377bf89df2849b97e98f204e1aa2cd3461578b9569c04522041306210df09446
• Download URL:
  https://stacks.cdc.gov/view/cdc/117817/cdc_117817_DS1.pdf
• File Type:
  [PDF - 762.51 KB ]