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Open Access Highly Accessed Research article

Colorectal cancer screening of high-risk populations: A national survey of physicians

Pascale M White1, Malini Sahu2, Michael A Poles1 and Fritz Francois1*

Author Affiliations

1 Division of Gastroenterology and Department of Medicine, New York University Langone Medical Center, New York, NY, USA

2 Division of Gastroenterology and Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA

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BMC Research Notes 2012, 5:64  doi:10.1186/1756-0500-5-64

Published: 24 January 2012

Abstract

Background

The incidence of colorectal cancer can be decreased by appropriate use of screening modalities. Patients with a family history of colon cancer and of African-American ethnicity are known to be at higher risk of developing colorectal cancer. We aimed to determine if there is a lack of physician knowledge for colorectal cancer screening guidelines based on family history and ethnicity. Between February and April 2009 an anonymous web-based survey was administered to a random sample selected from a national list of 25,000 internists, family physicians and gastroenterologists. A stratified sampling strategy was used to include practitioners from states with high as well as low CRC incidence. All data analyses were performed following data collection in 2009.

Results

The average knowledge score was 37 ± 18% among the 512 respondents. Gastroenterologists averaged higher scores compared to internists, and family physicians, p = 0.001. Only 28% of physicians correctly identified the screening initiation point for African-Americans while only 12% of physicians correctly identified the screening initiation point and interval for a patient with a family history of CRC. The most commonly cited barriers to referring high-risk patients for CRC screening were "patient refusal" and "lack of insurance reimbursement."

Conclusions

There is a lack of knowledge amongst physicians of the screening guidelines for high-risk populations, based on family history and ethnicity. Educational programs to improve physician knowledge and to reduce perceived barriers to CRC screening are warranted to address health disparities in colorectal cancer.