Abstract A49: Colorectal cancer screening practices by race and physician specialty

Abstract

Abstract Primary care physicians play a critical role in the provision of colorectal cancer screening. Differences in CRC screening practices among PCP may contribute to underutilization of CRC screening. Low colorectal cancer screening rates may be attributed to the differences in screening practices among primary care physicians (PCPs). These screening practices may also account for racial disparities in colorectal cancer. The purpose of this study was to compare the colorectal cancer screening practices of black and white Medicare beneficiaries based on the type primary care provider that they had. Study data were obtained from Medicare Current Beneficiary Survey (MCBS) with matched Medicare claims. There were a total of 3666 Medicare beneficiaries included in the study, aged 50 to 75, identified as white or black, and “usually” received care from an internist, family physician, or general practitioner. Two-year longitudinal survey weights were used in all the analyses. Colorectal cancer screening was defined as having had a sigmoidoscopy or colonoscopy within five years and/or a home fecal occult blood test within one year. Unadjusted and adjusted logistic regression analyses were performed with stratification by the race of the beneficiary and the physician specialty. Compared to internist, a significantly lower proportion of beneficiaries that received care from a family physician or a general practitioner had undergone colorectal cancer screening or knew that Medicare provided reimbursement for screenings. Both black and white beneficiaries that had a family physician or general practitioner as their PCP were less likely to undergo screening and less likely receive a recommendation for screening and they were also less likely to know that Medicare helps pay for testing. However, when the analyses were stratified by physician specialty using a specialty-race interaction term, compared to whites, blacks receiving care from a family physician or a general practitioner were less likely to receive a recommendation for a colonoscopy. These results indicate that family physicians and general practitioners may be providing lower quality care regarding colorectal cancer screening services, compared to internists. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A49.