Preferences for colorectal cancer screening tests and screening test use in a large multispecialty primary care practice

Authors

  • Sarah T. Hawley PhD, MPH,

    1. Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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  • Amy McQueen PhD,

    1. Division of Health Behavior Research, Washington University School of Medicine, St. Louis, Missouri
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  • L. Kay Bartholomew EdD, MPH,

    1. Center for Health Promotion and Prevention Research, Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Austin, Texas
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  • Anthony J. Greisinger PhD,

    1. Kelsey Research Foundation, Houston, Texas
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  • Sharon P. Coan MS,

    1. Center for Health Promotion and Prevention Research, Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Austin, Texas
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  • Ronald Myers PhD,

    1. Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, Pennsylvania
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  • Sally W. Vernon PhD

    Corresponding author
    1. Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, Texas
    • Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2560, Houston, TX 77030

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    • Fax: (713) 500-9750


Abstract

BACKGROUND:

The purpose of this study was to identify factors associated with colorectal cancer (CRC) screening test preference and examine the association between test preference and test completed.

METHODS:

Patients (n = 1224) were 50-70 years, at average CRC risk, and overdue for screening. Outcome variables were preference for fecal occult blood test (FOBT), colonoscopy (COL), sigmoidoscopy (SIG), or barium enema (BE), measured by telephone survey, and concordance between test preference and test completed assessed using medical records.

RESULTS:

Thirty-five percent preferred FOBT, 41.1% COL, 12.7% SIG, and 5.7% BE. Preference for SIG or COL was associated with having a physician recommendation, greater screening readiness, test-specific self-efficacy, greater CRC worry, and perceived pros of screening. Preference for FOBT was associated with self-efficacy for doing FOBT. Participants who preferred COL were more likely to complete COL compared with those who preferred another test. Of those screened, only 50% received their preferred test. Those not receiving their preferred test most often received COL (52%).

CONCLUSIONS:

Lack of concordance between patient preference and test completed suggests that patients' preferences are not well incorporated into screening discussions and test decisions, which could contribute to low screening uptake. Physicians should acknowledge patients' preferences when discussing test options and making recommendations, which may increase patients' receptivity to screening. Cancer 2011. © 2011 American Cancer Society.

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