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Colorectal Cancer Screening: Letting Patients Choose the Strategy Might Increase Adherence
Patients are more likely to undergo colorectal cancer screening when their primary care clinicians either recommend fecal occult blood testing or offer a choice between FOBT and colonoscopy, according to an Archives of Internal Medicine study.
Primary care clinicians serving an ethnically and racially diverse population were randomized to recommend screening by colonoscopy, FOBT, or a choice of the two. Nearly 1000 average-risk patients were included.
The primary outcome — completion of screening within 12 months — occurred significantly more often when patients were recommended FOBT (67%) or given a choice of FOBT or colonoscopy (69%) than when they were recommended only colonoscopy (38%). Nonwhites were more likely to undergo FOBT than were whites, while whites were more likely to undergo colonoscopy than nonwhites.
The authors conclude that "the common practice of universally recommending colonoscopy" may lower screening adherence. A commentator adds that giving patients a choice other than colonoscopy is "necessary."
Archives of Internal Medicine article (Free abstract)
Archives of Internal Medicine comment (Subscription required)
Published in Physician's First Watch April 10, 2012
- Colon cancer screening
Robert f Odell, Retired, 11 Apr 2012 12:53 PM EST
It may be a useful strategy to inform non-white patients that white patients more often choose colonoscopy because it is... [more]
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