Talk with Doctor Improves Colorectal Screening Chance

Rates rose during period, but screening still underutilized; best predictor is clinical discussion

WEDNESDAY, Feb. 13 (HealthDay News) -- Though screening rates for colorectal cancer rose between 2000 and 2003 within a large managed care health plan, screenings were still underutilized, indicating a need for interventions that also encourage providers to discuss colorectal screening with patients, according to research published online Feb. 11 in the journal Cancer.

Melissa M. Farmer, Ph.D., of the University of California Los Angeles, and colleagues analyzed data from telephone surveys conducted with patients aged 50 and older in 2000 and 2003, before and after an intervention to encourage colorectal cancer screening. In the first survey, 498 patients participated, and in the second 482 participated. The researchers examined patient barriers and facilitators to screening, and factors predicting screening.

Over this period, screening rates according to guidelines rose from 38 percent to 50 percent for any test; endoscopy rates rose from 23 percent to 39 percent; and fecal occult blood testing rose from 22 percent to 24 percent. The strongest predictor of screening was discussing colorectal cancer with the doctor, with an odds ratio of 2.86 for any test, 2.33 for endoscopy and 2.09 for fecal occult blood testing.

"These results suggest that interventions focused solely on educating patients are not likely to increase rates significantly. The provider and the health care system in which the provider practices must be able to include discussions and recommendations for colorectal cancer screening in practice to effectively increase colorectal cancer screening rates," the authors conclude.

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