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

DOI: 10.1186/1756-0500-5-64

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Abstract:

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."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.As the third leading cause of malignancy-related death in the United States, colorectal cancer (CRC) is expected to be responsible for over 50,000 deaths in 2011 [1,2]. While various CRC screening efforts have been implemented [3], notable disparities in screening prevalence exist among minorities, those with low incomes, lower education, as well as among individuals without health insurance [3].While some of the barriers that influence CRC screening rates include patient factors, as delineated above [4-6], there are also physician-related factors that should be considered, such as failure to recommend screening to patients [7-9]. The decision whether or not to adopt a screening strategy might be driven by both physician-perceived as well as real barriers such as patient co-morbidities, prior patient refusal of screening and lack of patient compliance, physician forgetfulness, time restrictions, and a lack of reminder systems and test tracking systems [10,11]. In addition, physician knowledge of current CRC screening guidelines may be an important contributing factor to screening referral practices.Primary care physician reco

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