For the integrated multidisciplinary approach to patient care

Return to the Southern Medical Journal

Current User S2 Access Level: -1 ()
CAN NOT ACCESS LEVEL 2
Original Article

Screening Preferences for Colorectal Cancer: A Patient Demographic Study

Rafiq A. Sheikh, MD, MRCP(UK), Sheela Kapre, MD, Olga M. Calof, MD, Coburn Ward, PHD, Ashu Raina, MD
Volume: 97 Issue: 3 March, 2004

Abstract:

Background: Colorectal cancer is a leading cause of cancer-related death. Screening for colorectal cancer is a rational and cost-effective strategy for reducing the incidence of colorectal cancer and related mortality. Despite endorsement by academic and health care organizations, patient awareness and compliance with screening is low, partly because of patient-related barriers to screening.


Methods: A convenience sample of adults attending the internal medicine and family practice clinics of a community teaching hospital was studied. A description of fecal occult blood testing (FOBT), sigmoidoscopy, and colonoscopy procedures was given in a packet along with a questionnaire. The questionnaire focused on screening procedures followed in our hospital (i.e., yearly FOBT and sigmoidoscopy every 5 years or colonoscopy every 10 years for average-risk individuals).


Results: Of the 193 patients who responded, 55% preferred sigmoidoscopy and FOBT, 29% chose colonoscopy, and 16% wanted no screening. Those with knowledge of someone with colon cancer or colon polyps reported a significantly higher preference for screening than those without such knowledge. Catholics were most likely to prefer no screening compared with non-Catholics. Ex-smokers (compared with all others) were more likely to want screening. Catholics were least likely to want colonoscopy. Patients with previous experience of colorectal screening preferred future screening. Those preferring no screening were significantly younger than those who expressed a preference for screening.


Conclusion: The results of this study demonstrate diversity in patient choices for colorectal cancer screening. A focus on people’s preferences rather than on the test itself may help develop and target appropriate intervention for prevention of colorectal cancer.

Article:

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

Images:

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

References:

1. American Cancer Society. Cancer Facts and Figures 2001. Atlanta, GA, American Cancer Society, Inc. Available at: http://www.cancer.org/downloads/STT/F&F2001.pdf. Accessed May 16, 2003.
 
2. Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999; 49: 33–64, 1.
 
3. Peeters M, Haller DG. Therapy for early-stage colorectal cancer. Oncology (Huntingt) 1999; 13: 307–321.
 
4. Winawer SJ, Zauber AG. The advanced adenoma as the primary target of screening. Gastrointest Endosc Clin N Am 2002; 12: 1–9, v.
 
5. Winawer SJ, Fletcher RH, Miller L, et al. Colorectal cancer screening: Clinical guidelines and rationale. Gastroenterology 1997; 112: 594–642.
 
6. Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy: The National Polyp Study Workgroup. N Engl J Med 1993; 329: 1977–1981.
 
7. Winawer SJ, Zauber AG, O’Brien MJ, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps: The National Polyp Study Workgroup. N Engl J Med 1993; 328: 901–906.
 
8. Fearon ER, Vogelstein B. A genetic model for colorectal tumorigenesis. Cell 1990; 61: 759–767.
 
9. Lieberman DA. Cost-effectiveness model for colon cancer screening. Gastroenterology 1995; 109: 1781–1790.
 
10. American Cancer Society. ACS cancer facts and figures. Cancer Pract 2000; 8: 105–108.
 
11. Lieberman DA, Weiss DG, Bond JH, et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer: Veterans Affairs Cooperative Study Group 380. N Engl J Med 2000; 343: 162–168.
 
12. Lieberman DA, Weiss DG. One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon. N Engl J Med 2001; 345: 555–560.
 
13. Imperiale TF, Wagner DR, Lin CY, et al. Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N Engl J Med 2000; 343: 169–174.
 
14. Scala M. Medicare preventive services. Issue Brief Cent Medicare Educ 2001; 2: 1–8.
 
15. Anderson LM, May DS. Has the use of cervical, breast, and colorectal cancer screening increased in the United States? Am J Public Health 1995; 85: 840–842.
 
16. Bloom Y, Figgs LW, Baker EA, et al. Data uses, benefits, and barriers for the behavioral risk factor surveillance system: A qualitative study of users. J Public Health Manag Pract 2000; 6: 78–86.
 
17. Ounpuu S, Krueger P, Vermeulen M, et al. Using the U.S. Behavior Risk Factor Surveillance System’s health related quality of life survey tool in a Canadian city. Can J Public Health 2000; 91: 67–72.
 
18. Burt RW. Colon cancer screening. Gastroenterology 2000; 119: 837–853.
 
19. Costanza ME, Hoople NE, Gaw VP, et al. Cancer prevention practices and continuing education needs of primary care physicians. Am J Prev Med 1993; 9: 107–112.
 
20. Pommerenke FA, Dietrich A. Improving and maintaining preventive services: Part 2—Practical principles for primary care. J Fam Pract 1992; 34: 92–97.
 
21. Wender RC. Cancer screening and prevention in primary care: Obstacles for physicians. Cancer 1993; 72 (3 Suppl): 1093–1099.
 
22. Ling BS, Moskowitz MA, Wachs D, et al. Attitudes toward colorectal cancer screening tests. J Gen Intern Med 2001; 16: 822–830.
 
23. Pignone M, Bucholtz D, Harris R. Patient preferences for colon cancer screening. J Gen Intern Med 1999; 14: 432–437.
 
24. Dominitz JA, Provenzale D. Patient preferences and quality of life associated with colorectal cancer screening. Am J Gastroenterol 1997; 92: 2171–2178.
 
25. Hegarty V, Burchett BM, Gold DT, et al. Racial differences in use of cancer prevention services among older Americans. J Am Geriatr Soc 2000; 48: 735–740.
 
26. Chao A, Gilliland FD, Hunt WC, et al. Increasing incidence of colon and rectal cancer among Hispanics and American Indians in New Mexico (United States), 1969–1994. Cancer Causes Control 1998; 9: 137–144.
 
27. Brown MO, Lanier AP, Becker TM. Colorectal cancer incidence and survival among Alaska Natives, 1969–1993. Int J Epidemiol 1998; 27: 388–396.
 
28. Mayberry RM, Coates RJ, Hill HA, et al. Determinants of black/white differences in colon cancer survival. J Natl Cancer Inst 1995; 87: 1686–1693.
 
29. Baquet CR, Commiskey P. Colorectal cancer epidemiology in minorities: A review. J Assoc Acad Minor Phys 1999; 10: 51–58.
 
30. Hoffman-Goetz L, Breen NL, Meissner H. The impact of social class on the use of cancer screening within three racial/ethnic groups in the United States. Ethn Dis 1998; 8: 43–51.
 
31. Roetzheim RG, Pal N, Tennant C, et al. Effects of health insurance and race on early detection of cancer. J Natl Cancer Inst 1999; 91: 1409–1415.
 
32. Weller DP, Owen N, Hiller JE, et al. Colorectal cancer and its prevention: Prevalence of beliefs, attitudes, intentions and behaviour. Aust J Public Health 1995; 19: 19–23.
 
33. Lacey L. Cancer prevention and early detection strategies for reaching underserved urban, low-income black women: Barriers and objectives. Cancer 1993; 72 (3 Suppl): 1078–1083.
 
34. Gregg J, Curry RH. Explanatory models for cancer among African-American women at two Atlanta neighborhood health centers: The implications for a cancer screening program. Soc Sci Med 1994; 39: 519–526.
 
35. Lantz PM, Reding D. Cancer: Beliefs and attitudes of migrant Latinos. JAMA 1994; 272: 31–32(letter).
 
36. Lantz PM, Dupuis L, Reding D, et al. Peer discussions of cancer among Hispanic migrant farm workers. Public Health Rep 1994; 109: 512–520.
 
37. Solis JM, Marks G, Garcia M, et al. Acculturation, access to care, and use of preventive services by Hispanics: Findings from HHANES 1982–1984. Am J Public Health 1990; 80 (Suppl): 11–19.
 
38. Trevino FM, Moyer ME, Valdez RB, et al. Health insurance coverage and utilization of health services by Mexican Americans, mainland Puerto Ricans, and Cuban Americans. JAMA 1991; 265: 233–237.
 
39. Leard LE, Savides TJ, Ganiats TG. Patient preferences for colorectal cancer screening. J Fam Pract 1997; 45: 211–218.
 
40. Elwood JM, Ali G, Schlup MM, et al. Flexible sigmoidoscopy or colonoscopy for colorectal screening: A randomized trial of performance and acceptability. Cancer Detect Prev 1995; 19: 337–347.
 

CME:

Portions of this issue may be available for CME credit. Please email education@sma.org for a complete listing of current Southern Medical Journal activities, as well as other SMA educational offerings.

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

Permissions