Patient and Physician Gender May Influence Colorectal Cancer Screening by Resident Physicians

Abstract

Colorectal cancer causes significant morbidity and mortality in the United States. Despite the publication and acceptance of screening guidelines, there is evidence that physicians inconsistently adhere to the recommendations. Recent data also suggest that women may thereby receive inadequate cancer surveillance. This study was designed to evaluate internal medicine residents' performance of colorectal cancer screening at The George Washington University Medical Center during 1989–1994. A retrospective chart review of 200 medical records (110 women, 90 men) revealed that resident physicians performed 85 (42.5%) rectal examinations, 95 (47.5%) fecal occult blood tests, and 21 (10.5%) flexible sigmoidoscopies. Among the 110 female patients, 41 (37.3%) had rectal examinations, 43 (39.1%) had fecal occult blood testing, and 13 (11.8%) had flexible sigmoidoscopies. Among the 90 male patients, 44 (48.9%) had rectal examinations, 52 (57.8%) had fecal occult blood testing, and 8 (8.9%) had flexible sigmoidoscopies. Male patients had significantly more (p < 0.008) fecal occult blood tests than female patients. In addition, female physicians performed more rectal examinations (p < 0.04) and fecal occult blood testing (p < 0.02) on their female patients than did male physicians. Male physicians performed more rectal examinations (p < 0.04) on their male patients than did female physicians. Efforts should be made to improve screening practices by resident physicians. Additional research should be conducted to evaluate the impact of patient and physician gender on the implementation of colorectal cancer screening guidelines.