UICC World Cancer Congress 2006

Objective:The WV Colorectal Cancer Initiative sought to identify factors associated with colorectal cancer (CRC) screening strategy recommendations among primary care physicians in West Virginia. While colorectal cancer (CRC) is largely preventable, it remains the second-leading cause of cancer-related deaths in the United States. Screening reduces colorectal cancer incidence and mortality; however, fewer than 50% of the adult US population 50 years of age and older are adherent to screening guidelines. Physician recommendation is a key predictor of CRC screening, yet few patients in West Virginia and the US report that they are receiving such recommendations

Methods:A questionnaire was mailed to all primary care physicians licensed to practice in West Virginia. Of the 1,258 eligible physicians, 567 (45%) returned completed questionnaires.

Results:Over 96% of the primary care physicians reported that they recommend CRC screening to their average-risk patients. Nearly one third (30.8%) recommend colonoscopy most often to their average risk patients, 7.3% recommend fecal occult blood test (FOBT) alone, and 19% recommend digital rectal exam and in-office FOBT. A majority of respondents reported that the capacity for performing colonoscopy (61.3%), flexible sigmoidoscopy (59.2%), and DCBE (77.7%) is either just about right or more than enough to meet demand. Factors predicting preferred screening method include physician training, attitudes towards screening procedures, perceived patient barriers, and system barriers. Major barriers to flexible sigmoidoscopy and colonoscopy reported by a majority of respondent include patient refusal/ poor patient compliance and patients finding the preparation unpleasant or inconvenient.