Factors associated with a physician's recommendation for colorectal cancer screening in a diverse population

Abstract

Background and objectives: Colorectal cancer (CRC) screening is widely recommended but underused. A physician's recommendation for CRC screening has been consistently associated with patients undergoing CRC screening, but a better understanding of factors influencing a physician's recommendation for CRC screening is needed. This study's purpose was to describe patient and physician factors associated with a physician's recommendation for CRC screening.

Methods: A cross-sectional survey was conducted in a primary care clinic population during 2004-2005 to determine the association between self-reported physician recommendation for CRC testing and patients' sociodemographic factors, health characteristics, other health behaviors, and physician and patient-physician factors including patient-physician gender and racial/ethnic congruence. Bivariate and multivariate logistic regressions were performed.

Results: A total of 560 patients ages 50-80 were recruited. Their mean age was 63 years, 47.5% were male, 36% were non-Hispanic whites, 35% were African Americans, and 29% were Hispanics. Sixty-one percent reported receiving a physician's recommendation for CRC testing. In multivariate testing, a physician's recommendation for CRC testing was associated with having a female physician, being a male patient, having gastrointestinal disease, and having better health status.

Conclusions: Female physicians are more likely to recommend CRC. Patients are more likely to receive a CRC recommendation if they are male, have gastrointestinal disease, and have better health status. Further studies should explore cultural influences on physician recommendation for screening.