Colorectal cancer screening and surveillance practices by primary care physicians

Results of a national survey

Virender K. Sharma, Rajeev Vasudeva, Colin Howden

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

OBJECTIVE: Screening for colorectal cancer reduces its morbidity and mortality and is cost-effective. Screening is usually the responsibility of primary care physicians who may be unsure about its implementation. We aimed to assess primary care physicians' knowledge and practice regarding colorectal cancer screening, and to compare their responses with those of three national experts and with published guidelines. METHODS: We mailed a postal questionnaire to 2310 primary care physicians regarding demographics, nature of practice, use of screening tests, and six hypothetical patients who may have been candidates for screening or surveillance. We used published national guidelines and the collective opinions of the three external experts as the so-called 'gold standard.' RESULTS: Of all respondents, 85.1% offered colorectal cancer screening. Most used suitable tests, starting at an appropriate age; 49.8% continued screening indefinitely irrespective of patients' age and 43.6% performed fecal occult blood testing without appropriate dietary advice to patients. Also, respondents frequently performed this test for inappropriate indications. Only 51.8% would follow a positive fecal occult blood test with colonoscopy. CONCLUSIONS: Colorectal cancer screening practices by primary care physicians vary considerably from those recommended. Many offer screening to individuals in whom it is not appropriate, and continue it into advanced age. Frequent, inappropriate use of fecal occult blood tests will produce many false positives. Primary care physicians often do not appropriately follow a positive test. Further educational efforts are needed in an attempt to improve practice and further reduce the morbidity and mortality from colorectal cancer. (C) 2000 Am. Coll. of Gastroenterology.

Original languageEnglish (US)
Pages (from-to)1551-1556
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume95
Issue number6
DOIs
StatePublished - Jun 1 2000

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Primary Care Physicians
Early Detection of Cancer
Colorectal Neoplasms
Occult Blood
Hematologic Tests
Guidelines
Morbidity
Mortality
Gastroenterology
Colonoscopy
Demography
Surveys and Questionnaires
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Colorectal cancer screening and surveillance practices by primary care physicians : Results of a national survey. / Sharma, Virender K.; Vasudeva, Rajeev; Howden, Colin.

In: American Journal of Gastroenterology, Vol. 95, No. 6, 01.06.2000, p. 1551-1556.

Research output: Contribution to journalArticle

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