Patients whose physicians recommend colonoscopy and those who follow through

Abstract

Background: More than half of eligible individuals are not up-to-date with colon cancer screening.

Purpose: To assess the characteristics of those who received a colonoscopy screening recommendation and those who followed the physician recommendation.

Methods: Patient self-administered questionnaire and medical record review in 16 private family physician practices.

Results: From 8372 patients invited to participate, 685 were enrolled and had a medical record review; 219 (32%) had a colonoscopy recommendation and 86 (39%) received a colonoscopy. Independent factors associated with having a recommendation for colonoscopy were significantly younger in age (odds ratios [OR] = 1.6), higher incomes (annual income ≥$40 000 vs <$40 000; OR = 1.8), physician or nurse discussion about colon cancer tests (OR = 1.6), physical visit in the preceding 26 months (OR = 1.7), distant relative with colon cancer (OR = 2.4), and a medical diagnosis of hyperlipidemia (OR = 2.1). Independent factors associated with following through on colonoscopy after a recommendation were age ≥65 years (OR = 0.3), male patient (OR = 0.4), and feeling that colon cancer screening is very important (OR = 3.2).

Conclusions: Socioeconomic factors are associated with receipt of a colonoscopy recommendation. Fewer than one third of patients had documentation of a physician colonoscopy recommendation and of those, less than half followed through.

Keywords: colonoscopy; colorectal cancer; colorectal cancer screening; practice-based research network.