Identifying opportunities for improved colorectal cancer screening in primary care

Parita Patel, Samuel N. Forjuoh, Andrejs Avots-Avotins, Tushar Patel

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background. Although current recommendations advocate screening persons 50 years of age or older for colorectal cancer (CRC), actual screening practice is highly variable among primary care physicians (PCPs). Knowledge of the factors that influence whether or not screening is offered during a clinic visit is essential to develop effective screening strategies. Methods. A cross-sectional telephone survey of one in four randomly selected patients aged 50 years or older (n = 400) attending a primary care clinic within an integrated health care system in central Texas was conducted. A survey of all PCPs (n = 32) at the practice sites was also administered. Results. The visit type was an important determinant of whether CRC screening was discussed, with most discussion occurring during visits for physicals (P < 0.0001). This finding was corroborated by the physician survey. Patient age and education were also associated with a higher likelihood of having been offered CRC screening (P = 0.009 and 0.014, respectively). Patient race, gender, primary language, PCP, or clinics attended were not significantly associated with the discussion of CRC screening. Conclusions. Discussions regarding CRC screening are most likely to occur during preventive care visits. Thus, facilitating preventive visits especially for the elderly represents an opportunity to improve CRC screening rates in primary care practice.

Original languageEnglish (US)
Pages (from-to)239-246
Number of pages8
JournalPreventive Medicine
Issue number2
StatePublished - Aug 2004


  • BE
  • CI
  • CRC
  • CS
  • Cancer screening
  • Colorectal cancer screening
  • FOBT
  • FS
  • Health care practice
  • OR
  • PCP
  • Prevention
  • barium enema
  • colonoscopy
  • confidence intervals
  • crude odds ratio
  • fecal occult blood test
  • flexible sigmoidoscopy
  • primary care physician

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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