Are Doctors Recommending Enough Colorectal Cancer Screenings?

Jordan Baeker Bispo, Ph.D., MPH, chief scientist of cancer disparity research for the American Cancer Society, and colleagues undertook the current study to determine the prevalence of clinician recommendations for colorectal screening among underscreened adults. To accomplish this, the researchers designed their study utilizing data from 61,479 patients who completed the 2019 and 2021 National Health Interview Surveys. Patients had to be age-eligible for screening, assessed for guideline-concordant screening, not up to date with screening recommendations, and have had a wellness visit in the previous year to be eligible for the study.

Colorectal Cancer Screening

The researchers assessed whether participants had received a physician referral for colorectal cancer screening by asking, “In the past 12 months, did a doctor or other health professional recommend that you be tested to look for problems in your colon or rectum?” Only responders who did not report guideline-concordant colorectal cancer screening were asked to complete the survey. The proportion of reporting a clinician’s suggestion for screening was calculated using age, survey year, gender, race/ethnicity, education, poverty status, nativity, urban or rural domicile, comorbidity burden, insurance, and usual source of treatment. Unadjusted and adjusted prevalence ratios were estimated using logistic regression models.

The study comprised 5022 patients who were both eligible and late for colorectal cancer screening. 1425 (26.8%) of these participants reported having a clinician recommendation for colorectal cancer screening. Prevalence was lowest among patients who did not have a typical source of care (9.7%) and were uninsured (12.6%), while estimates were similar in a sensitivity analysis that excluded respondents who did not have insurance or a usual source of care.

Non-Hispanic Asian (adjusted prevalence ratio [aPR], 0.53 [95% CI, 0.37-0.75]), non-Hispanic Black (aPR, 0.76 [95% CI, 0.63-0.92]), and Hispanic (aPR, 0.82 [95% CI, 0.67-1.01] adults were less likely than non-Hispanic White adults to report a clinician recommendation for colorectal cancer screening. Furthermore, receiving a clinician recommendation was less likely for those with less than a high school education (aPR, 0.76 [95% CI, 0.61-0.95]) compared to those with a college diploma, as well as for uninsured adults (aPR, 0.51 [95% CI, 0.38-0.68]) compared to those with private insurance.

Loopholes in Colorectal Cancer Screening

“The findings highlight a major communication gap about [colorectal cancer] prevention in the clinical setting. At the systems level, investing in clinician training, automated point-of-care prompts, educational tools for shared decision-making with diverse patient populations, and community outreach may improve patient-clinician communication about [colorectal cancer] screening and advance progress toward national screening goals,” concluded investigators.

References :

1. Receipt of Clinician Recommendation for Colorectal Cancer Screening Among Underscreened U.S. Adults – (https://pubmed.ncbi.nlm.nih.gov/37696035/)
2. Cancer Stat Facts: Colorectal Cancer – (https://seer.cancer.gov/statfacts/html/colorect.html)
3. Colorectal Cancer: Screening – (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening)
4. U.S. Cancer Statistics Colorectal Cancer Stat Bite – (https://www.cdc.gov/cancer/uscs/about/stat-bites/stat-bite-colorectal.htm)

Source: Medindia