Primary Care Physicians CRC Screening Recommendations and Practices
Objectives: This study assessed primary care physicians' beliefs about colorectal cancer (CRC) screening
effectiveness, their screening recommendations, the influence of guidelines on their recommendations, and how they
conduct CRC screening in their clinical practices.
Results: Only 2 percent did not recommend CRC screening; over 80 percent most often recommended
CRC screening with fecal occult blood testing (FOBT) and/or flexible sigmoidoscopy (FS) (although colonoscopy was
perceived as a more effective screening modality); and only 29 percent performed FS. Estimated volumes of ordering,
performing, or referring for CRC screening were low, and 20 percent reported that three-fourths or more of their older
patients were up to date with CRC screening as recommended by the physician. Many primary care physicians reported
recommending CRC screening at nonstandard starting ages or too-frequent intervals.
Conclusions: Opportunities for improvement include educating primary care physicians and the public
about the importance of CRC screening; revision of guidelines to include information on timing and frequency of screening;
development of systems to identify and track eligible patients; and further research on patient, provider, and system
barriers that contribute to low rates of CRC screening.
Reference: Klabunde CN, Frame PS, Meadow A, Jones E, Nadel M, Vernon SW. A national survey of primary
care physicians' colorectal cancer screening recommendations and practices. Prev Med 2003 Mar;36(3):352-62.