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January/February 2009 Annals of Family Medicine tip sheet
Date:1/12/2009

Colorectal Cancer Screening: Opportunity and Challenges in Primary Care

Four articles and an editorial in the January/February issue of Annals look at the issue of colorectal cancer screening and the role of primary care in early detection. Colorectal cancer is the second leading cause of cancer death in the United States, in part because only slightly more than one-half of eligible adults aged 50 years and older report being up-to-date with screening.

In a meta-analysis of 12 studies on the outcomes of screening colonoscopies performed by primary care physicians, Wilkins and colleagues find that colonoscopies performed by primary care physicians appear to be safe and effective, with quality, safety and efficacy indicators comparable to those recommended by specialty societies. Analyzing quality measures from colonoscopies performed on 18,292 patients by primary care physicians, the researchers find that several standard measures of proficiency are similar to those reported for colonoscopies by gastroenterologist specialists. Given the growing demand for screening colonoscopy and the current shortage of endoscopists, they conclude that primary care physicians could play a fundamental role in expanding access.

Using nationally representative data on 120,221 patients, Cardarelli and Thomas show that having a personal health care provider is associated with a three times higher likelihood of colorectal cancer screening. They also find that patients who are older, female, non-Hispanic and white, and have a higher level of education, income and health insurance are more likely to be up-to-date for colorectal cancer testing. Although these covariates are significant predictors, having a personal health care provider has the highest odds of predicting up-to-date screening. They conclude that policy-driven initiatives to ensure all people have access to a primary care clinician may be a strategic method to improving colorectal c
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Contact: Angela Sharma
asharma@aafp.org
913-269-2269
American Academy of Family Physicians
Source:Eurekalert

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