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191

CURRENT COLORECTAL CANCER SCREENING PRACTICES AND TEST RECOMMENDATIONS OF PRIMARY CARE PHYSICIANS

RL Walker, SE McGregor, RJ Hilsden, G Currie, SJ Heitman, AM Irving, J Bergman, D Sadowski
Alberta Cancer Board; University of Alberta, Edmonton; University of Calgary, Calgary, Alberta

OBJECTIVE: To determine primary care physicians' current colorectal cancer (CRC) screening practices and what screening tests they recommend for patients and for themselves.
METHODS: Self-administered mailed questionnaires were completed by 156 Alberta primary care physicians as part of a study determining preferences for CRC screening. Information on current CRC screening practices was collected.
RESULTS: Most physicians were in group practice (80%) and had been practicing for >15 years (53%). Nearly all physicians (89%) are convinced that CRC screening is beneficial for their patients. The vast majority (92%) recommend CRC screening for average risk patients. Most of these physicians (88%) recommend screening starting at age 50-59 and 63% recommend screening to at least 75% of their patients. However only 33% believe that at least 75% of their patients actually complete the test. Two basic approaches were used for average risk patients presenting for routine check-ups: (1) 40% discuss the issue of CRC screening and see if the patient is interested; and (2) 55% suggest the patient undergo screening as part of their routine exam. Most physicians (60%) recommend a specific screening test while 38% present a number of screening options. Physician screening test preference for patients and for themselves is depicted in the table below (multiple responses allowed).
                              

Physician CRC screening test preference:	For patients n (%)	For themselves n (%)
Home FOBT	139 (89)	53 (34)
Colonoscopy	72 (46)	94 (60)
Flexible sigmoidoscopy	27 (17)	3(2)
CT colonography	12 (8)	10(6)
None of the above	31 (20)	5(3)

CONCLUSION: The majority of primary care physicians are convinced CRC screening is beneficial and recommend screening to their patients. However, physicians perceive low uptake of screening tests. The most common screening test recommendation for patients was FOBT and for themselves was colonoscopy. The potential gap between physician screening recommendation and patient compliance needs to be further investigated.
RL Walker is supported by an AHFMR Graduate Studentship

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