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

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.