Trainees’ knowledge and application of guideline recommendations for colorectal cancer screening and surveillance

Abstract

BackgroundData shows that practicing physicians don't recommend colorectal (CRC) screening and surveillance as suggested by guidelines. We assessed knowledge of CRC guidelines in medical trainees. MethodsA survey assessing confidence and knowledge of published CRC guidelines was emailed to program directors (PDs) of Accreditation Council of Graduate Medical Education approved training programs in the United States. PDs were requested to forward it to trainees. We analyzed trainees’ knowledge by answers to clinical vignettes and identification of factors required by guidelines for screening and post polypectomy colonoscopy interval. We compared confidence and knowledge by specialty. Results586 trainees in internal medicine (159), family medicine and primary care (147), gastroenterology (114), general surgery (51), ob/gyn (78), urology (13), and colorectal surgery (13) responded. 97% reported following guidelines. 68% and 50% stated confidence recalling screening and surveillance guidelines, respectively. 16% and 8% correctly identified all factors and answered corresponding vignettes for screening and surveillance, respectively. Overall accuracy of screening ranged between 11–23% and was not different between specialties (p = 0.11) while significant differences were noted between specialties in surveillance knowledge (0–39%, p < 0.001). ConclusionsUnited States trainees’ CRC screening and surveillance knowledge is poor. Measures are needed to enhance knowledge of CRC guidelines.