Preferences for colorectal cancer screening tests and screening test use in a large multispecialty primary care practice

BACKGROUND: The purpose of this study was to identify factors associated with colorectal cancer (CRC) screening test preference and examine the association between test preference and test completed. METHODS: Patients (n = 1224) were 50‐70 years, at average CRC risk, and overdue for screening. Outco...

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Bibliographic Details
Published in:Cancer 2012-05, Vol.118 (10), p.2726-2734
Main Authors: Hawley, Sarah T., McQueen, Amy, Bartholomew, L. Kay, Greisinger, Anthony J., Coan, Sharon P., Myers, Ronald, Vernon, Sally W.
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Colonoscopy
colorectal cancer
Colorectal Neoplasms - diagnosis
decision making
Early Detection of Cancer - methods
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Male
Medical sciences
Middle Aged
Multivariate Analysis
Occult Blood
patient education
Primary Health Care
screening
Sigmoidoscopy
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumors
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Summary:BACKGROUND: The purpose of this study was to identify factors associated with colorectal cancer (CRC) screening test preference and examine the association between test preference and test completed. METHODS: Patients (n = 1224) were 50‐70 years, at average CRC risk, and overdue for screening. Outcome variables were preference for fecal occult blood test (FOBT), colonoscopy (COL), sigmoidoscopy (SIG), or barium enema (BE), measured by telephone survey, and concordance between test preference and test completed assessed using medical records. RESULTS: Thirty‐five percent preferred FOBT, 41.1% COL, 12.7% SIG, and 5.7% BE. Preference for SIG or COL was associated with having a physician recommendation, greater screening readiness, test‐specific self‐efficacy, greater CRC worry, and perceived pros of screening. Preference for FOBT was associated with self‐efficacy for doing FOBT. Participants who preferred COL were more likely to complete COL compared with those who preferred another test. Of those screened, only 50% received their preferred test. Those not receiving their preferred test most often received COL (52%). CONCLUSIONS: Lack of concordance between patient preference and test completed suggests that patients' preferences are not well incorporated into screening discussions and test decisions, which could contribute to low screening uptake. Physicians should acknowledge patients' preferences when discussing test options and making recommendations, which may increase patients' receptivity to screening. Cancer 2011. © 2011 American Cancer Society. Lack of concordance between patient preference and test completed suggests that patients' preferences are not well incorporated into screening discussions and test decisions, which may hinder screening completion. Physicians should acknowledge patients' preferences when discussing test options and making recommendations, which may increase patients' receptivity to screening.
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.26551