Screening for colorectal cancer by primary-care physicians in Long Island (New York) and Connecticut

Cancer Detect Prev. 1989;13(5-6):301-9.

Abstract

Postal questionnaires on colorectal cancer screening practices were received from samples of primary-care physicians in Long Island, New York (LI-NY) (N = 190, 66.4% response rate), and in Connecticut (N = 215, 71.7% response rate). About 90% reported ever screening asymptomatic patients 50 years of age or older by fecal occult-blood test (FOBT), and 76-86% reported generally recommending such screening annually. Proportions who generally recommended screening by proctoscopy, 48% in LI-NY and 54% in CT, were higher than those reported in a 1984 survey by the American Cancer Society. About 40-43% of physicians, however, reported using proctoscopy (i.e., flexible sigmoidoscopy [FS]) only if the FOBT was positive. The major factors influencing screening by FS were the low probability of finding a lesion, cost to the patient, and patient fear or discomfort. Training in the use of FS, reported by 25-35% of physicians, was significantly more frequent in younger physicians (i.e., less than 50 vs. 50+ years of age). Differences in responses between physicians in LI-NY and CT were generally small. Over 90% of physicians reportedly obtained information on family history of cancer and 77-80% on family history of colorectal cancer for asymptomatic patients 40 years of age and older. A pragmatic approach to increasing screening for colorectal cancer is discussed, emphasizing higher-risk patients as defined by family history of cancer and personal medical history.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Colorectal Neoplasms / prevention & control*
  • Connecticut
  • Humans
  • Mass Screening
  • New York
  • Occult Blood
  • Physicians, Family / education
  • Proctoscopy / statistics & numerical data
  • Sigmoidoscopy / statistics & numerical data