 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
K. Allen Greiner, MD, MPH1, Kimberly K. Engelman, PhD2, Matthew A. Hall, PhD3, and Edward F. Ellerbeck, MD, MPH2. (1) School of Medicine, University of Kansas, Department of Family Medicine, 3901 Rainbow Blvd., Kansas City, KS 66160, 913-588-1931, agreiner@kumc.edu, (2) Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160-7313, (3) The Kansas Cancer Institute, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160
Background: Colorectal Cancer (CRC) is the second leading cause of cancer death in the United States. The American Cancer Society estimates 148,300 new cases and 56,600 deaths from CRC for 2002. A significant body of research shows that clinical screening methodologies can reduce both the incidence of new cases and deaths. Despite clinical guidelines, screening tests are utilized at significantly lower rates than tests for other detectable cancers such as breast cancer. This study examined patients’ perceptions of their discussion with their physicians regarding colorectal cancer screening and physicians’ attitudes towards colorectal cancer screening modalities.
Methods: Cross-sectional survey of 801 patients over 50 years of age in 36 primary care practices in rural Kansas in 2002.
Results: The 801 patients surveyed were predominately Caucasian (94%) and female (61%) with a mean age of 69 years. Only 57% of the patients reported being up-to-date with their colorectal cancer screening, with 37% of the patients reported receiving a fecal occult blood test (FOBT) within the past two years and 54% of patients indicated having either a colonoscopy or sigmoidoscopy within the past five years. Most patients (61%) reported not discussing or having inadequate time to discuss CRC screening with their physicians. Patients who reported having adequate time to discuss CRC screening were more up-to-date on their CRC screening than patients who reported not discussing or having inadequate time to discuss CRC screening (76% vs. 45%, p < 0.001).
Of the 36 primary care practices, 58% could perform colonoscopies while 75% could perform sigmoidoscopies. Physicians’ preferences for CRC screening methods varied, with 36% reporting a preference for annual FOBT plus sigmoidoscopy every 5 years, 31% reporting a preference for annual FOBT alone, and 31% reporting a preference for colonoscopy alone. Patients seen by physicians with colonoscopy available on-site had reported lower rates of FOBT (58% vs. 75%, p < 0.001). The major barriers to CRC screening that physicians reported were patient test acceptance and compliance.
Conclusions: Patient and physician preferences, as well as practice characteristics, impact CRC screening compliance. The majority of patients feel that their time to discuss colorectal cancer screening is inadequate. Improving physician-patient dialogue about CRC screening may enhance CRC screening utilization in rural practices.
Learning Objectives:
Keywords: Cancer Screening, Rural Health Care
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.