American Journal of Preventive Medicine
Volume 37, Issue 1 , Pages 8-16 , July 2009

Colorectal Cancer Screening by Primary Care Physicians: Recommendations and Practices, 2006–2007

  • Carrie N. Klabunde, PhD

      Affiliations

    • Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda
    • Corresponding Author InformationAddress correspondence and reprint requests to: Carrie N. Klabunde, PhD, Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, EPN 4005, 6130 Executive Boulevard, Bethesda MD 20892-7344
  • ,
  • David Lanier, MD

      Affiliations

    • Center for Primary Care, Prevention, and Clinical Partnerships, the Agency for Healthcare Research and Quality, Rockville
  • ,
  • Marion R. Nadel, PhD

      Affiliations

    • Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
  • ,
  • Caroline McLeod, PhD

      Affiliations

    • Westat, Rockville
  • ,
  • Gigi Yuan, MS

      Affiliations

    • Information Management Services, Inc., Silver Spring, Maryland
  • ,
  • Sally W. Vernon, PhD

      Affiliations

    • Division of Health Promotion and Behavioral Sciences, University of Texas–Houston School of Public Health, Houston, Texas

References 

  1. American Cancer Society. Cancer facts and figures 2008. Atlanta GA: American Cancer Society; 2008;
  2. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–1595
  3. U.S. Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:627–637
  4. Maciosek MV, Coffield AB, Edwards NM, et al. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med. 2006;31:52–61
  5. Shapiro JA, Seeff LC, Thompson TD, et al. Colorectal cancer test use from the 2005 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev. 2008;17:1623–1630
  6. Breen N, Cronin KA, Meissner HI, et al. Reported drop in mammography: is this cause for concern?. Cancer. 2007;109:2405–2409
  7. Solomon D, Breen N, McNeel T. Cervical cancer screening in the U.S. and the potential impact of implementation of screening guidelines. CA Cancer J Clin. 2007;57:105–111
  8. Klabunde CN, Meissner HI, Wooten KG, et al. Comparing colorectal cancer screening and immunization status in older Americans. Am J Prev Med. 2007;33:1–8
  9. Subramanian S, Klosterman M, Amonkar MM, Hunt TL. Adherence with colorectal cancer screening guidelines: a review. Prev Med. 2004;38:536–550
  10. Brawarsky P, Brooks DR, Mucci LA, Wood PA. Effect of physician recommendation and patient adherence on rates of colorectal cancer testing. Cancer Detect Prev. 2004;28:260–268
  11. Janz NK, Wren PA, Schottenfeld D, Guire KE. Colorectal cancer screening attitudes and behavior: a population-based study. Prev Med. 2003;627–634
  12. Hudson SV, Ohman-Strickland P, Cunningham R, et al. The effects of teamwork and system support on colorectal cancer screening in primary care practices. Cancer Detect Prev. 2007;31:417–423
  13. Sarfaty M, Wender R. How to increase colorectal cancer screening rates in practice. CA Cancer J Clin. 2007;57:354–366
  14. Klabunde CN, Frame PS, Meadow A, et al. A national survey of primary care physicians' colorectal cancer screening recommendations and practices. Prev Med. 2003;36:352–362
  15. Centers for Medicare & Medicaid Services. Colorectal cancer screening: overview. www.cms.hhs.gov/ColorectalCancerScreening/
  16. U.S. Preventive Services Task Force. Screening for colorectal cancer: recommendation and rationale. Ann Intern Med. 2002;137:129–131
  17. National Committee for Quality Assurance. HEDIS & quality measurement, HEDIS archives, HEDIS. Washington DC: National Committee for Quality Assurance; 2004;www.ncqa.org/tabid/346/Default.aspx
  18. Pignone M, Rich M, Teutsch SM, Berg AO, Lohr KN. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:132–141
  19. Meissner HI, Breen N, Klabunde CN, Vernon SW. Patterns of colorectal cancer screening uptake among men and women in the U.S. Cancer Epidemiol Biomarkers Prev. 2006;15:389–394
  20. Schenck AP, Peacock S, Klabunde CN, et al. Trends in colorectal cancer test use in the Medicare population, 1998–2005. Am J Prev Med. 2009;37:1–7
  21. Chen X, White MC, Peipens LA, Seeff LC. Increase in screening for colorectal cancer in older Americans: results from a national survey. J Am Geriatr Soc. 2008;56:1511–1516
  22. Smith RA, Cokkinides V, von Eschenbach AC, et al. American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2002;52:8–22
  23. Winawer S, Fletcher R, Rex D, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale—update based on new evidence. Gastroenterology. 2003;124:544–560
  24. Griffith JM, Lewis CL, Brenner AR, Pignone MP. The effect of offering different numbers of colorectal cancer screening test options in a decision aid: a pilot randomized trial. BMC Med Inform Decis Mak. 2008;8:4
  25. Marshall DA, Johnson FR, Phillips KA, et al. Measuring patient preferences for colorectal cancer screening using a choice-format survey. Value Health. 2007;10:415–430
  26. Janz NK, Lakhani I, Vijan S, et al. Determinants of colorectal cancer screening use, attempts, and non-use. Prev Med. 2007;44:452–458
  27. Wolf RL, Basch CE, Brouse CH, Shmukler C, Shea S. Patient preferences and adherence to colorectal cancer screening in an urban population. Am J Public Health. 2006;96:809–811
  28. Dolan JG. Patient priorities in colorectal cancer screening decisions. Health Expect. 2005;8:34–44
  29. Denberg TD, Melhado TV, Coombes JM, et al. Predictors of nonadherence to screening colonoscopy. J Gen Intern Med. 2005;20:989–995
  30. Pignone M, Bucholtz D, Harris R. Patient preferences for colon cancer screening. J Gen Intern Med. 1999;14:432–437
  31. Katsumura Y, Yasunaga H, Imamura T, Ohe K, Oyama H. Relationship between risk information on total colonoscopy and patient preferences for colorectal cancer screening options: analysis using the analytic hierarchy process. BMC Health Serv Res. 2008;8:106
  32. DeBourcy AC, Lichtenberger S, Felton S, et al. Community-based preferences for stool cards versus colonoscopy in colorectal cancer screening. J Gen Intern Med. 2007;23:169–174
  33. Podolsky DK. Going the distance: the case for true colorectal cancer screening. New Eng J Med. 2000;343:207–208
  34. Rex DK, Johnson DA, Lieberman DA, Burt RW, Sonnenberg A. Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology. Am J Gastroenterol. 2000;95:868–877
  35. Lewis JD, Asch DA. Barriers to office-based screening sigmoidoscopy: does reimbursement cover costs?. Ann Intern Med. 1999;130:525–530
  36. Lewis JD, Asch DA, Ginsberg GG, et al. Primary care physicians' decisions to perform flexible sigmoidoscopy. J Gen Intern Med. 1999;14:297–302
  37. Krist AH, Jones RM, Woolf SH, et al. Timing of repeat colonoscopy: disparity between guidelines and endoscopists' recommendation. Am J Prev Med. 2007;33:471–478
  38. Mysliwiec PA, Brown ML, Klabunde CN, Ransohoff DF. Are physicians doing too much colonoscopy? (A national survey of colorectal surveillance after polypectomy). Ann Intern Med. 2004;141:264–271
  39. Guerra CE, Schwartz JS, Armstrong K, et al. Barriers of and facilitators to physician recommendation of colorectal cancer screening. J Gen Intern Med. 2007;22:1681–1688
  40. Levy BT, Nordin T, Sinift S, Rosenbaum M, James PA. Why hasn't this patient been screened for colon cancer? (An Iowa Research Network Study). J Am Board Fam Med. 2007;20:458–468
  41. Wei EK, Ryan CT, Dietrich AJ, Colditz GA. Improving colorectal cancer screening by targeting office systems in primary care practices: disseminating research results into clinical practice. Arch Intern Med. 2005;165:661–666
  42. Vogt T. Improving CRC screening requires innovative approaches: can electronic medical records help?. Am J Prev Med. 2008;35:317–318
  43. Schenck AP, Klabunde CN, Warren JL, et al. Data sources for measuring colorectal endoscopy use among Medicare enrollees. Cancer Epidemiol Biomarkers Prev. 2007;16:2118–2127
  44. Schenck AP, Klabunde CN, Warren JL, et al. Evaluation of self-report, claims, and medical records for measuring fecal occult blood testing among Medicare enrollees in fee-for-service. Cancer Epidemiol Biomarkers Prev. 2008;17:799–804
  45. Vogelaar I, van Ballegooijen M, Schrag D, et al. How much can current interventions reduce colorectal cancer mortality in the U.S.? (Mortality projections for risk-factor modification, screening, and treatment). Cancer. 2006;107:1624–1633

 The full text of this article is available via AJPM Online at www.ajpm-online.net.

PII: S0749-3797(09)00202-5

doi: 10.1016/j.amepre.2009.03.008

American Journal of Preventive Medicine
Volume 37, Issue 1 , Pages 8-16 , July 2009