Doctors Don't Recommend Colorectal Screening Often Enough

Armen Hareyan's picture

Colorectal Cancer Screening

Since 1996, federal health officials have recommended that people 50 years and older be screened for colorectal cancer with a fecal occult blood test. However, a new analysis of data shows that only 17.2 percent actually received such screening in the previous year.

The study of 12,477 men and women, by Steven S. Coughlin, Ph.D., and Trevor Thompson of the Centers for Disease Control and Prevention, also shows that only 33.9 percent of those 50 and older were evaluated for colorectal cancer during the previous 10 years with either sigmoidoscopy or colonoscopy, the most common screening procedures after the fecal occult blood test (FOBT).

Of those who did not have an FOBT in the previous year, 22.9 percent said they were not tested primarily because no doctor ordered the procedure. Similarly, the study reveals that 21.6 percent of those who did not have a sigmoidoscopy or colonoscopy in the past 10 years said they had not undergone such procedures primarily because physicians had not ordered them.

Coughlin said the study in the latest issue of Health Promotion Practice underscores the importance of doctors recommending colorectal cancer screening.


The risks posed by colorectal cancer increase sharply from age 50, and the American Cancer Society and others recommend several screening options: annual FOBTs or sigmoidoscopies every five years or both and colonoscopies every 10 years or as required by FOBT results.

The FOBT is a simple, inexpensive procedure that takes seconds to perform in an outpatient setting.

Colorectal cancer is the third most common type of cancer in the United States and the second leading cause of cancer death after lung cancer. More than 57,000 Americans die each year of the disease, and early detection can reduce the disease's death toll.

A host of factors that may enable or impede the use of screening procedures are assessed by the study. The analysis associates older age and shorter duration of residency in the United States with not having a physician recommendation for colorectal cancer screening. It also says that having less education and non-White race/ethnicity may be factors in not having a physician recommendation for screening.

Durado Brooks, M.D., director of prostate and colorectal cancers for the American Cancer Society, said the study "strongly supports the view of the ACS" that there is not enough screening for colorectal cancer because "physicians simply are not recommending it enough."

The data come from the National Health Interview Survey, which is conducted annually by the government with in-person interviews in about 36,000 households.


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