Skip to main content

Advertisement

SpringerLink
Log in

Colorectal cancer screening perceptions and practices: Results from a national survey of gastroenterology, surgery and radiology trainees

  • Articles
  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Background. Colorectal cancer (CRC) screening in the United States is suboptimal. We conducted a national survey to learn about CRC screening perceptions and practices among trainees who perform CRC screening tests including those enrolled in Gastroenterology and Hepatology (GIH), General and Colorectal Surgery, and Diagnostic and Abdominal Radiology training programs.Methods. Program directors/administrators (PDs/PAs) from 642 programs were contacted by e-mail with an invitation to forward our survey to trainees in their programs. Participating trainees then completed an anonymous, Web-based questionnaire.Results. A total of 130/642 (20%) PDs/PAs forwarded our survey to their trainees, with responses received from 476 trainees (80 GIH, 261 surgery, 135 radiology). Colonoscopy was felt to be the best CRC screening test at reducing CRC mortality, with patient-related factors perceived as greater barriers than system-related factors. No single guideline was deemed very influential on CRC screening practices by most trainees. A total of 2 of 5 above-average risk patient profiles were not recognized by most trainees. Colonoscopy was selected as the preferred follow-up test for a positive CRC screening test by most trainees. However, 34% of respondents chose an option other than colonoscopy alone for follow-up of a positive fecal occult blood test.Conclusions. Based on data from this national survey of gastroenterology, surgery, and radiology trainees, opportunities exist for curricular changes that may help enhance current perceptions and practices of trainees who perform CRC screening tests.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jemal A, Siegal R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56:106–130.

    Article  PubMed  Google Scholar 

  2. Winawer S, Fletcher R, Rex D, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update on new evidence. Gastroenterology. 2003;124:544–560.

    Article  PubMed  Google Scholar 

  3. Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006;130:1872–1885.

    Article  PubMed  Google Scholar 

  4. Rex DK, Kahi CJ, Levin B, et al. Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2006;130:1865–1871.

    Article  PubMed  Google Scholar 

  5. Increased use of colorectal cancer tests—United States, 2002 and 2004. MMWR Morb Mortal Wkly Rep. 2006;55:308–311.

    Google Scholar 

  6. Harewood GC, Wiersema MJ, Melton LJ III. A prospective, controlled assessment of factors influencing acceptance of screening colonoscopy. Am J Gastroenterol. 2002;97:3186–3194.

    Article  PubMed  Google Scholar 

  7. Janz NK, Wren PA, Schottenfeld D, et al. Colorectal cancer screening attitudes and behavior: a population-based study. Prev Med. 2003;37(pt 1):627–634.

    Article  PubMed  Google Scholar 

  8. Taylor V, Lessler D, Mertens K, et al. Colorectal cancer screening among African Americans: the importance of physician recommendations. J Natl Med Assoc. 2003;95:806–812.

    PubMed  Google Scholar 

  9. Klabunde CN, Vernon SW, Nadel MR, et al. Barriers to colorectal cancer screening: a comparison of reports from primary care physicians and average-risk adults. Med Care. 2005;43:939–944.

    Article  PubMed  Google Scholar 

  10. Barrison AFC, Smith C, Oviedo J, et al. Colorectal cancer screening and familial risk: a survey of internal medicine residents’ knowledge and practice patterns. Am J Gastroenterol. 2003;98:1410–1416.

    Article  PubMed  Google Scholar 

  11. Borum ML. Medical residents’ colorectal cancer screening may be dependent in ambulatory care education. Dig Dis Sci. 1997;42:1176–1178.

    Article  CAS  PubMed  Google Scholar 

  12. Sharma VK, Corder FA, Raufman JP, et al. Survey of internal medicine residents’ use of the fecal occult blood test and their understanding of colorectal cancer screening and surveillance. Am J Gastroenterol. 2000;95:2068–2073.

    Article  CAS  PubMed  Google Scholar 

  13. Mysliwiec PA, Brown ML, Klabunde CN, et al. Are physicians doing too much colonoscopy? A national survey of colorectal surveillance after polypectomy. Ann Intern Med. 2004;141:264–271.

    PubMed  Google Scholar 

  14. Sharma VK, Corder FA, Fancher J, et al. Survey of the opinions, knowledge and practices of gastroenterologists regarding colorectal cancer screening and the use of the fecal occult blood test. Am J Gastroenterol. 2000;95:3629–3632.

    Article  CAS  PubMed  Google Scholar 

  15. Smith RA, Cokkinides V, von Eschenbach AC, et al. American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2002;52:8–22.

    Article  PubMed  Google Scholar 

  16. US Preventive Services Task Force. Screening for colorectal cancer: recommendation and rationale. Ann Intern Med. 2002;137:129–131.

    Google Scholar 

  17. Terhaar Sive Droste JS, Heine GD, Craanen ME, et al. On attitudes about colorectal cancer screening among gastrointestinal specialists and general practitioners in the Netherlands. World J Gastroenterol. 2006;12:5201–5204.

    CAS  PubMed  Google Scholar 

  18. Hay J, Coups E, Ford J. Predictors of perceived risk for colon cancer in a national probability sample in the United States. J Health Commun. 2006;11(suppl 1):71–92.

    Article  PubMed  Google Scholar 

  19. Vernon SW. Participation in colorectal cancer screening: a review. J Natl Cancer Inst. 1997;89:1406–1422.

    Article  CAS  PubMed  Google Scholar 

  20. Subramanian S, Klosterman BA, Amonkar MM, Hunt TL. Adherence with colorectal cancer screening guidelines: a review. Prev Med. 2004;38:536–550.

    Article  PubMed  Google Scholar 

  21. Shokar NK, Vernon SW, Weller SC. Cancer and colorectal cancer: knowledge, beliefs, and screening preferences of a diverse patient population. Fam Med. 2005;37:341–347.

    PubMed  Google Scholar 

  22. Wong BC, Chan AO, Wong WM, et al. Attitudes and knowledge of colorectal cancer and screening in Hong Kong: a population-based study. J Gastroenterol Hepatol. 2006;21:41–46.

    Article  PubMed  Google Scholar 

  23. Matthews BA, Anderson RC, Nattinger AS. Colorectal cancer screening behavior and health insurance status (United States). Cancer Causes Control. 2005;16:735–742.

    Article  PubMed  Google Scholar 

  24. Shieh K, Gao F, Ristvedt S, et al. The impact of physicians’ health beliefs on colorectal cancer screening practices. Dig Dis Sci. 2005;50:809–814.

    Article  PubMed  Google Scholar 

  25. Alberto VO, Harocopos CJ, Patel AA, et al. Family and personal history in colorectal cancer patients: what are we missing? Colorectal Dis. 2006;8:612–614.

    Article  CAS  PubMed  Google Scholar 

  26. Grover S, Stoffel EM, Bussone L, et al. Physician assessment of family history and referral for genetic evaluation in colorectal cancer patients. Clin Gastroenterol Hepatol. 2004;2:813–819.

    Article  PubMed  Google Scholar 

  27. Schroy PC III, Glick JT, Geller AC, et al. A novel educational strategy to enhance internal medicine residents’ familial colorectal cancer knowledge and risk assessment skills. Am J Gastroenterol. 2005;100:677–684.

    Article  PubMed  Google Scholar 

  28. Hlavaty T, Lukac L, Huorka M, et al. Positive family history promotes participation on colorectal cancer screening. Bratisl Lek Listy. 2005;106:318–323.

    CAS  PubMed  Google Scholar 

  29. Nadel MR, Shapiro JA, Klabunde CN, et al. A national survey of primary care physicians’ methods for screening for fecal occult blood. Ann Intern Med. 2005;142:86–94.

    PubMed  Google Scholar 

  30. Braithwaite D, Emery J, De Lusignan S, et al. Using the Internet to conduct surveys of health professionals: a valid alternative? Fam Pract. 2003;20:545–551.

    Article  PubMed  Google Scholar 

  31. Raziano DB, Jayadevappa R, Valenzula D, et al. E-mail verus conventional postal mail survey of geriatric chiefs. Gerontologist. 2001;41:799–804.

    CAS  PubMed  Google Scholar 

  32. Leece P, Bhandari M, Sprague S, et al. Internet versus mailed questionnaires: a controlled comparison. J Med Internet Res. 2004;6:e39.

    Article  PubMed  Google Scholar 

  33. VanDenKerkhof EG, Parlow JL, Goldstein DH, et al. In Canada, anesthesiologists are less likely to respond to an electronic, compared to paper questionaire. Can J Anaesth. 2004;51:449–454.

    Article  PubMed  Google Scholar 

  34. Rodriguez HP, von Glahn T, Rogers WH, et al. Evaluating patient’s experiences with individual physicians: a randomized trial of mail, internet, and interactive voice response telephone administration of surveys. Med Care. 2006;44:167–174.

    Article  PubMed  Google Scholar 

  35. McMahon SR, Iwamoto M, Massoudi MS, et al. Comparison of email, fax and postal surveys of pediatricians. Pediatrics. 2003;111(pt 1): e299-e303.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mayo Clinic College of Medicine, 200 First Street SW, 55905, Rochester, MN

    Amy S. Oxentenko MD, Robert A. Vierkant MS, Darrell S. Pardi MD, David R. Farley MD, Eric J. Dozois MD, Thomas E. Hartman MD, David M. Hough MD, Wesley O. Petersen PhD & Paul J. Limburg MD, MPH (Associate Professor of Medicine, Miles and Shirley Fiterman Center for Digestive Diseases)

  2. Health Services and Economic Branch, National Cancer Institute, Bethesda, MD

    Carrie N. Klabunde PhD

  3. American Cancer Society, Atlanta, GA

    Katherine Sharpe MTS & Robert A. Smith PhD

  4. Veterans’ Administration Medical Center, Minneapolis, MN

    John H. Bond MD

  5. U.T.M.D. Anderson Cancer Center, Houston, TX

    Bernard Levin MD

  6. Louisiana State University, Shreveport, LA

    John B. Pope MD

  7. Boston Medical Center, Boston, MA

    Paul C. Schroy MD

Authors
  1. Amy S. Oxentenko MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert A. Vierkant MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Darrell S. Pardi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David R. Farley MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eric J. Dozois MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas E. Hartman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David M. Hough MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Wesley O. Petersen PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Carrie N. Klabunde PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Katherine Sharpe MTS
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. John H. Bond MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Robert A. Smith PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Bernard Levin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. John B. Pope MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Paul C. Schroy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Paul J. Limburg MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul J. Limburg MD, MPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oxentenko, A.S., Vierkant, R.A., Pardi, D.S. et al. Colorectal cancer screening perceptions and practices: Results from a national survey of gastroenterology, surgery and radiology trainees. J Canc Educ 22, 219 (2007). https://doi.org/10.1007/BF03174120

Download citation

  • DOI: https://doi.org/10.1007/BF03174120

Keywords

Search

Navigation