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Primary care physician counselling improves participation in colonoscopy

The Scandanavian Journal of Gastroenterology evaluated the effect of primary care physician counselling on participation rate and use of sedation in colonoscopy-based colorectal cancer screening program.

News image

Physician recommendation is a strong predictor of colorectal cancer (CRC) screening adherence, but there are no sufficient data specific to primary colonoscopy screening programs.

Dr Jaroslaw Regula and colleagues from Poland compared the effect of primary care physician's counseling with information leaflet about colorectal cancer screening on participation rate in opportunistic primary colonoscopy screening program.

The team's secondary objective was to determine the impact of this counseling on a decision to choose unsedated colonoscopy.

The team evaluated 600 consecutive subjects 50–65 years of age visiting primary care physician's group practice for routine medical consultation.

Participation rate was 47% in the counseling group
Scandanavian Journal of Gastroenterology

The subjects were randomly assigned in a 1:1 ratio either to discuss colorectal cancer screening with the primary care physician or to receive an information leaflet on colorectal cancer screening only.

The outcome measures were the participation rate and the proportion of unsedated colonoscopies assessed on subjects' self-reports collected 6 months after the intervention.

The research team investigated the association between independent covariates and binary endpoints.

The team reported that participation rate was 47% in the counseling group, and 14% in the information leaflet group.

The rates of unsedated colonoscopies were 77% and 39%, respectively.

In a multivariate analyses, primary care physician's counseling was associated with higher participation in colorectal cancer screening and higher rate of unsedated colonoscopies.

Dr Regula's team concludes, "In opportunistic primary colonoscopy screening, primary care physician's counseling significantly increases participation rate and decreases demand for sedation compared to recruitment with information materials only."

Scand J Gastroenterol 2014: 49(7): 878-884
25 July 2014

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