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Abstract
BackgroundThe incidence of colorectal cancer can be decreased by appropriate use of screening modalities. Patients with a family history of colon cancer and of African-American ethnicity are known to be at higher risk of developing colorectal cancer. We aimed to determine if there is a lack of physician knowledge for colorectal cancer screening guidelines based on family history and ethnicity. Between February and April 2009 an anonymous web-based survey was administered to a random sample selected from a national list of 25,000 internists, family physicians and gastroenterologists. A stratified sampling strategy was used to include practitioners from states with high as well as low CRC incidence. All data analyses were performed following data collection in 2009.ResultsThe average knowledge score was 37 ± 18% among the 512 respondents. Gastroenterologists averaged higher scores compared to internists, and family physicians, p = 0.001. Only 28% of physicians correctly identified the screening initiation point for African-Americans while only 12% of physicians correctly identified the screening initiation point and interval for a patient with a family history of CRC. The most commonly cited barriers to referring high-risk patients for CRC screening were "patient refusal" and "lack of insurance reimbursement."ConclusionsThere is a lack of knowledge amongst physicians of the screening guidelines for high-risk populations, based on family history and ethnicity. Educational programs to improve physician knowledge and to reduce perceived barriers to CRC screening are warranted to address health disparities in colorectal cancer.
Highlights
The incidence of colorectal cancer can be decreased by appropriate use of screening modalities
Given that opportunities for screening referral exist across medical disciplines, investigating physician knowledge about colorectal cancer (CRC) screening guidelines in various specialties might reveal modifiable factors that impact the adoption of screening strategies at physician-patient contact points
We aimed to investigate physician knowledge of CRC screening guidelines based on family history as well as ethnicity among three medical specialties, while evaluating barriers for compliance with established CRC screening guidelines
Summary
The incidence of colorectal cancer can be decreased by appropriate use of screening modalities. We aimed to determine if there is a lack of physician knowledge for colorectal cancer screening guidelines based on family history and ethnicity. High-risk individuals such as those with a family history of colorectal cancer may not be screened as necessary at the appropriate initiation point or interval if not identified appropriately or if the guidelines are unknown [14]. Few studies have assessed physician knowledge about colorectal cancer screening guidelines for high-risk patient populations across specialties, nor have any examined physician barriers to appropriate colorectal cancer screening of high-risk patients with a family history of colorectal lesions, or of ethnically diverse patients. We hypothesized that there is a gap in physician knowledge regarding colorectal cancer screening of these high-risk patient populations, and that there are modifiable physician barriers to appropriate colon cancer screening of high-risk patient populations
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