Prevalence of Colorectal Cancer Screening in a Large Medical Organization

Abstract

The primary objective of this study was to determine the prevalence of colorectal cancer (CRC) screening among eligible patients in a large medical practice. A secondary objective was to compare CRC screening rates obtained from medical records with physician self-reported CRC screening recommendation. We conducted a retrospective record review of 214 patients ages > 50 years of a large multispecialty medical organization in Houston, Texas, for receipt of fecal occult blood test (FOBT), flexible sigmoidoscopy (SIG), and/or colonoscopy (COL). We estimated prevalence using two definitions: (a) FOBT in past year or SIG in past 5 years or COL in past 10 years; and (b) FOBT in past year and SIG in past 5 years or COL in past 10 years. Age, gender, race/ethnicity, family history, number of chronic conditions, and index visit were independent variables. Contingency table and logistic regression analysis were used to test for associations between outcomes and independent variables. Our study population was 48% male with a mean age of 63 years (range: 53-84 years). One-quarter of the records showed FOBT by 3-day kit (51 of 214) and 27% by digital rectal exam (57 of 214). SIG was recorded in 32% of records. Half (54%) of the records had documentation of CRC screening according to definition no. 1 and 19% according to definition no. 2. Screening rates from medical record review were lower than those derived from physician self-report. Our findings underscore the need for interventions to improve CRC screening in primary care settings. IntroductionColorectal cancer (CRC) is the fourth most common cancer and the second leading cause of cancer death in the United States.

Recruitment in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial: the First Phase of Recruitment at Henry Ford Health System

“…A number of studies have indicated that African-American women are less likely to use mammography, although data from the National Health Interview Study indicate no difference (28). In contrast with our findings, Heflin et al observed an increased use of mammography with morbidity unrelated to mobility, whereas Hawley et al observed colorectal screening to be positively associated with age and not related to sex (29,30). Age seems to be inversely related to cervical cancer screening, although the relationship of mammography utilization and age has been observed to be nonlinear (31).…”

Physician colorectal cancer screening recommendations: An examination based on informed decision making

“…An interesting follow-up study would involve an examination of actual physician-patient interactions or an examination of medical records. Similar to the findings of Hawley et al [26], we expect to conclude that our role play data collection resulted in an over-reporting of informed decision making elements. In addition, our participants all volunteered for this study, and therefore, our results are limited by self-selection bias.…”

Reliability and Validity of a Questionnaire to Measure Colorectal Cancer Screening Behaviors: Does Mode of Survey Administration Matter?

“…KSC delivers primary and specialty care to >400,000 patients and has a staff of 119 primary care physicians (family and internal medicine) and seven gastroenterologists. The prevalence of any CRCS among KSC patients, defined as home-based FOBT within the past year, SIG within the past 5 years, or COL within the past 10 years, was 54% in 2000 (17).…”