Despite evidence-based recommendations for colorectal carcinoma screening, population-based surveys report low screening rates.
The extent to which screening procedures are used by patients seen in primary care is not as clear.
Dr Elston Lafata and colleagues from Michigan estimated the annual and 5-year colorectal carcinoma screening procedure use among a cohort of primary care patients.
The researchers evaluated the correlation between patient characteristics and the use of screening procedures.
The team identified a cohort of 21,833 patients between 55 and 70 years who had a primary care visit in 2003 and were enrolled in a 5-year health plan ending 2003.
The researchers used automated data for the 5-year period ending using information on patient sociodemographic characteristics.
The researchers also used information on primary care and health maintenance examination visits, comorbid diagnoses, income, and screening receipt.
| Colonoscopy was used most frequently in 40%|
Information was also compiled on barium enema, colonoscopy, fecal occult blood testing, and flexible sigmoidoscopy use.
The team noted that 54% of primary care patients received recommended colorectal carcinoma screening procedures over the 5-year observation period.
Among individuals who received screening, colonoscopy was used most frequently in 40%, followed by flexible sigmoidoscopy testing alone in 28%.
The researchers observed that colonoscopy was also used in combination with fecal occult blood testing in 4%.
Annual screening rates increased by 3% between 1999 and 2003.
Among individuals who did not receive recommended colorectal carcinoma screening, 64% had at least 3 health maintenance examination visits.
The team also noted that 41% of those not receiving colorectal carcinoma screening had at least 1 fecal occult blood test.
Increasing health maintenance visits and other primary care visit frequency, were associated with screening receipt.
In addition, the researchers found that increasing age, income, male gender, and African-American race, were associated with screening receipt.
Dr Elston Lafata's team concluded, “Significant opportunities exist to increase colorectal carcinoma screening among primary care patients.”