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

Abstract

What is already known on this topic?Colorectal cancer (CRC) screening among average-risk patients is underused in the US. Clinician recommendation is strongly associated with screening completion.What is added by this report?We examined clinicians' routine recommendations of 7 guidelinerecommended screening methods and factors associated with these recommendations.What are the implications for public health practice?A sizable portion of clinicians reported guideline-discordant screening intervals and age to stop screening. Recommendation of screening methods varied by clinician-perceived effectiveness of the method, familiarity with the method, Medicare coverage, clinical capacity, and patient adherence. Clinician education is needed to improve knowledge, familiarity, and experiences with guideline-recommended screening methods with the goal of effectively engaging patients in informed decision making for CRC screening.

Limited English proficiency and reported receipt of colorectal cancer screening among adults 45–75 in 2019 and 2021

“…Colonoscopies were the most recommended modality, while stool-based tests made up less than a quarter of recommended tests, and few adults reported being recommended multiple modalities. This is consistent with prior research that has shown healthcare professionals prefer colonoscopies due to preference for visual inspection and concern regarding the sensitivity/specificity of stool-based tests ( Finney Rutten et al, 2022 , Zhu et al, 2022 ). However, it is important to incorporate patient preferences into CRC recommendations as adults who are given a choice of modalities have higher rates of screening completion ( Inadomi et al, 2012 ).…”

Evaluation of Colonoscopy and Sigmoidoscopy Utilization for Colorectal Cancer Screening in Georgia, USA

“…About 37% of patients preferred colonoscopy, compared to 31% and 9% who preferred blood stool test and sigmoidoscopy, respectively. Further educational interventions are needed to provide clinicians with complete understanding of the CRC screening process, including up-to-date guidelines for recommended screening modalities and consideration of patient, clinician, and health system factors that may impact the effectiveness of each method [ 9 ].…”

“…In 2021, the American College of Gastroenterology (ACG) recommended CRC screening in average-risk individuals between the ages of 45 and 75 [ 7 , 8 ]. There are several CRC screening modalities currently available including blood stool tests, sigmoidoscopy, and colonoscopy [ 7 , 8 , 9 ].…”