Patients whose physicians recommend colonoscopy and those who follow through

J Prim Care Community Health. 2013 Apr 1;4(2):83-94. doi: 10.1177/2150131912464887. Epub 2012 Nov 4.

Abstract

Background: More than half of eligible individuals are not up-to-date with colon cancer screening.

Purpose: To assess the characteristics of those who received a colonoscopy screening recommendation and those who followed the physician recommendation.

Methods: Patient self-administered questionnaire and medical record review in 16 private family physician practices.

Results: From 8372 patients invited to participate, 685 were enrolled and had a medical record review; 219 (32%) had a colonoscopy recommendation and 86 (39%) received a colonoscopy. Independent factors associated with having a recommendation for colonoscopy were significantly younger in age (odds ratios [OR] = 1.6), higher incomes (annual income ≥$40 000 vs <$40 000; OR = 1.8), physician or nurse discussion about colon cancer tests (OR = 1.6), physical visit in the preceding 26 months (OR = 1.7), distant relative with colon cancer (OR = 2.4), and a medical diagnosis of hyperlipidemia (OR = 2.1). Independent factors associated with following through on colonoscopy after a recommendation were age ≥65 years (OR = 0.3), male patient (OR = 0.4), and feeling that colon cancer screening is very important (OR = 3.2).

Conclusions: Socioeconomic factors are associated with receipt of a colonoscopy recommendation. Fewer than one third of patients had documentation of a physician colonoscopy recommendation and of those, less than half followed through.

Keywords: colonoscopy; colorectal cancer; colorectal cancer screening; practice-based research network.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Colonoscopy / psychology*
  • Colonoscopy / statistics & numerical data
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / prevention & control*
  • Early Detection of Cancer / psychology*
  • Early Detection of Cancer / statistics & numerical data
  • Family Health
  • Family Practice / methods
  • Family Practice / standards*
  • Female
  • Humans
  • Iowa
  • Male
  • Medical Records
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pilot Projects
  • Professional-Patient Relations
  • Randomized Controlled Trials as Topic
  • Reminder Systems
  • Socioeconomic Factors
  • Surveys and Questionnaires