242350 Physician recommendation as a predictor of participation in colorectal cancer screening: A population-based study of South Carolina adults

Monday, October 31, 2011

Heather M. Brandt, PhD, CHES , Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, SC
Heather Dolinger, MS, PhD candidate , University of South Carolina Arnold School of Public Health, Columbia, SC
Patricia A. Sharpe, PhD, MPH , Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC
James W. Hardin, PhD , Department of Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC
Purpose: The purpose of this study was to examine the association of physician recommendation to colorectal cancer screening (CRC).

Methods: The study was a cross-sectional, random digit dialed (landline; cell phone numbers) survey using computer-assisted telephone interviews. South Carolina residents aged 45-75 years were contacted. For this paper, analysis was restricted to participants aged 50-75 (n=1,302) who fell in the age range for CRC screening guidelines. Odds ratios were adjusted for race and gender.

Results: Participants who reported physician recommendation for CRC screening tests were more likely to have had that test: fecal occult blood test (FOBT) (OR=3.39, CI 2.64, 4.35); flexible sigmoidoscopy (FS) (OR=117.04, CI 77.36, 177.08); colonoscopy (OR=58.36, CI 38.81, 87.76); and any type of CRC screening test (OR=26.32, CI 17.45, 39.72). Those reporting physician recommendation were also more likely to intend to have each test: FOBT in next 12 months (OR=1.92, CI 1.51, 2.47); FS in next five years (OR=2.82, CI 2.19, 3.63); colonoscopy in next 10 years (OR=7.05, CI 5.25, 9.48); and any type of CRC screening test (OR=5.66, CI 3.94, 8.13) compared to those not reporting recommendation. African-American (AA) participants were more likely to report physician recommendation for FOBT (OR=1.57, CI 1.18, 2.09); FS in the next five years (2.97, CI 2.23, 3.96); and more likely to intend to have colonoscopy (OR=1.53, CI 1.07, 2.19) compared to white participants.

Conclusion: Physician recommendation for CRC screening was significantly connected to CRC screening. Intervention efforts to increase physician recommendation are warranted given the significant effect.

Learning Areas:
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Discuss the role of physician recommendation in predicting participation in cancer screening, specifically colorectal cancer screening. 2. Describe the benefits of conducting assessment at the population level. 3. Formulate potential interventions to increase physician recommendation.

Keywords: Cancer Screening, Public Health Education and Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Graduate research assistant who actively contributed to the research process
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.