Association of Regional Variation in Primary Care Physicians' Colorectal Cancer Screening Recommendations with Individual Use of Colorectal Cancer Screening
Studies show that the recommendations of a primary care physician for colorectal
cancer screening may be one important influence on an individual's use of
screening. However, another possible influence, the effect of regional
differences in physicians' beliefs and recommendations on screening use, has not
We linked data from the National Health Interview Survey on the use of colorectal cancer
screening by respondents aged 50 years or older, by hospital-referral region, with data
from the Survey of Colorectal Cancer Screening Practices on the colorectal cancer
screening recommendations of primary care physicians, by region. Our principal independent
variables were the proportion of physicians in a region who recommended screening at age
50 and continuing screening at the recommended frequency.
On average, 53.3% of physicians in a region correctly recommended initiating colorectal
cancer screening, and 64.8% advised screening at the recommended frequency. Of adults who
lived in regions where less than 30% of physicians correctly recommended initiating
screening, 47.3% had been screened, in contrast to 54.8% in areas where 70% or more of
physicians made correct recommendations. Seventy-one percent of respondents living in
regions where less than 30% of physicians advised screening at the recommended frequency
were current on screening, in contrast to 79.9% of respondents living in regions where 70%
or more of physicians made this recommendation. These differences were statistically
significant after adjustment for individual characteristics.
Strategies to improve colorectal cancer screening recommendations
of primary care physicians may improve the use of screening for millions of Americans.
Haas JS, Fitzmaurice G, Brawarsky P, Liang SY, Hiatt RA, Klabunde CN, Brown ML, Phillips KA.
Association of regional variation in primary care physicians' colorectal cancer screening recommendations with individual use of colorectal cancer screening.
Prev Chronic Dis 2007 Oct;4(4):A90.