Abstract
Little is known about strategies that physicians use to encourage receipt of colorectal cancer screening (CRCS). This study conducted focus groups with physicians. Twenty-seven physicians participated in four focus groups. Physicians described four categories of approaches: (1) why screening is important, (2) providing test information, (3) motivational strategies, and (4) tailoring strategies. Participants reported tailoring based on their relationship with a patient, as well as to patient gender, education, and language. Tailoring to cultural background or ethnicity was not prominent. Most physicians reported a typical approach to CRCS and reported some tailoring based on gender, education, and language, but not on ethnicity.
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References
American Cancer Society (2008) Cancer facts and figures
Kronborg O et al (1996) Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet 348(9040):1467–1471
Hardcastle J et al (1983) Controlled trial of faecal occult blood testing in the detection of colorectal cancer. Lancet 2(8340):1–4
Mandel JS et al (1999) Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst 91(5):434–437
Levin B et al (2008) Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology 134(5):1570–1595
Morbidity and Mortality Weekly Report (2006) Increased use of colorectal cancer tests—United States, 2002 and 2004. MMWR 55(11):308–311
Perez-Stable EJ et al (1994) Self-reported use of cancer screening tests among Latinos and Anglos in a prepaid health plan. Arch Intern Med 154:1073–1081
Perez-Stable EJ, Sabogal F, Otero-Sabogal R (1995) Use of cancer screening tests in the San Francisco Bay area: comparison of Latinos and Anglos. Monog J Natl Cancer Inst 18:147–153
Nguyen T et al (2002) Predictors of cervical pap smear screening recognition, intention, and receipt among Vietnamese-American women. Am J Prev Med 23(3):207–214
Garner E (2003) Cervical cancer: disparities in screening, treatment, and survival. Cancer Epidemiol Biomark Prev 12(3):242s–247s
Harlan LC, Bernstein AB, Kessler LG (1991) Cervical cancer screening: who is not screened and why? Am J Publ Health 81:885–890
Ioannou GN, Chapko MK, Dominitz JA (2003) Predictors of colorectal cancer screening participation in the United States. Am J Gastroenterol 98(9):2082–2091
O'Malley A et al (1999) Acculturation and breast cancer screening among Hispanic women in New York City. Am J Public Health 89(2):219–227
Jenkins C et al (1996) Health care access and preventive care among Vietnamese immigrants: do traditional beliefs and practices pose barriers? Soc Sci Med 43(7):1049–1056
Harper AP (1993) Mammography utilization in the poor and medically underserved. Cancer 72(Suppl):1478–1482
Wee CC, McCarthy EP, Phillips RS (2005) Factors associated with colon cancer screening: the role of patient factors and physician counseling. Prev Med 41(1):23–29
USPSTF (2008) Screening for colorectal cancer: U.S. Preventive services task force recommendation statement. Ann Intern Med 149(9):627–637
Sleath B, Rubin RH (2002) Gender, ethnicity, and physician–patient communication about depression and anxiety in primary care. Patient Educ Couns 48(3):243–252
Walsh J et al (2004) Barriers to colorectal cancer screening in Latino and Vietnamese Americans. J Gen Intern Med 19:156–166
Kelly R, Shank J (1992) Adherence to screening flexible sigmoidoscopy in asymptomatic patients. Med Care 30(11):1029–1042
Brenes G, Paskett E (2000) Predictors of stage of adoption for colorectal cancer screening. Prev Med 31(4):410–416
Weitzman E et al (2001) Risk and reluctance: understanding impediments to colorectal cancer screening. Prev Med 32(6):502–513
Bao Y, Fox SA, Escarce JJ (2007) Socioeconomic and racial/ethnic differences in the discussion of cancer screening: “between-” versus “within-” physician differences. Health Serv Res 42(3 Pt 1):950–970
Cooper-Patrick L et al (1999) Race, gender, and partnership in the patient–physician relationship. JAMA 282:583–589
Johnson RL et al (2004) Patient race/ethnicity and quality of patient–physician communication during medical visits. Am J Public Health 94(12):2084–2090
Brach C, Fraser I (2000) Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev 57(Suppl 1):181–217
Culhane-Pera K et al (2000) Multicultural curricula in family practice residencies. Fam Med 32(3):167–173
Kreps G, Kunimoto E (1994) Effective communication in multicultural health care settings. Sage, Thousand Oaks
Tervalon M, Murray-Garcia J (1998) Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved 9(2):117–125
Pasick R, D'Onofrio C, Otero-Sabogal R (1996) Similarities and differences across cultures: questions to inform a third generation for health promotion research. Health Educ Q 23(S):s142–s161
Cave A et al (1995) Physicians and immigrant patients. Cross-cultural communication. Can Fam Physician 41:1685
Cooper LA et al (2003) Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med 139(11):907–915
Ghods BK et al (2008) Patient–physician communication in the primary care visits of African Americans and Whites with depression. J Gen Intern Med 23(5):600–606
Johnson CD et al (1996) Barium enema: detection of colonic lesions in a community population. AJR Am J Roentgenol 167(1):39–43
Goa G et al (2009) Considering culture in physician–patient communication during colorectal cancer screening. Qual Health Res 19:778–789
ATLAS.ti. ATLAS.ti Qualitative data analysis
Smith R, Hoppe R (1991) The patient’s story: integrating the patient- and physician-centered approaches to interviewing. Ann Intern Med 115(6):470–477
Merriam-Webster (2008) Definition of culture. Merriam-Webster dictionary
Ling BS, Klein WM, Dang Q (2006) Relationship of communication and information measures to colorectal cancer screening utilization: results from HINTS. J Health Commun 11(Suppl 1):181–190
Pasick RJ, Burke NJ, Barker JC, Joseph G, Bird JA, Otero-Sabogal R, Tuason N, Stewart SL, Rakowski W, Clark MA, Washington PK, Guerra C (2009) Behavioral theory in a diverse society: like a compass on Mars. Health Educ Behav 36:11S–35S
Taylor V et al (2002) A randomized controlled trial of interventions to promote cervical cancer screening among Chinese women in North America. J Natl Cancer Inst 94(9):670–677
Pasick R et al. (2003) Outcome of a tailored print and phone counseling trial to increase cancer screening in five ethnic groups. 27th Annual Meeting of the American Society of Preventive Oncology, Philadelphia, PA
Champion VL et al (2002) Comparisons of tailored mammography interventions at two months postintervention. Ann Behav Med 24(3):211–218
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This study was supported by the National Cancer Institute grant 5R01CA95594.
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Walsh, J.M.E., Karliner, L., Burke, N. et al. Physicians’ Approaches to Recommending Colorectal Cancer Screening: A Qualitative Study. J Canc Educ 25, 385–390 (2010). https://doi.org/10.1007/s13187-010-0058-1
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DOI: https://doi.org/10.1007/s13187-010-0058-1