Published in Cancer Detection and Prevention 2004; 28(4).

Effect of physician recommendation and patient adherence on rates of colorectal cancer testing

P. Brawarsky, MPH, D.R. Brooks DSc, L.A. Mucci ScD, P.A. Wood MD

Bureau of Health Statistics, Research and Epidemiology, Massachusetts Department of Public Health, Massachusetts, USA

This study explored: (1) patient characteristics associated with physician recommendation for colorectal cancer (CRC) screening and patient adherence to recommendation, and (2) the combined effect of recommendation and adherence on CRC testing, broadly defined. Data were from the 1999 MA BRFSS and a call-back survey of 869 BRFSS participants, age 50 and older. Logistic regression was used to identify correlates of recommendation, adherence, and testing. Patient­physician factors were positively associated with recommendation, adherence and testing. Inadequate health insurance was negatively associated with recommendation (OR = 0.45, 95% CI = 0.27­0.78) and testing (OR = 0.64, 95% CI = 0.38­1.1). Men were not more likely to be recommended (OR = 1.1, 95% CI = 0.78­1.5), but were more likely to adhere (OR = 1.9, 95% CI = 1.2­2.0) and to be tested (OR = 1.4, 95% CI = 1.0­1.9). There were gender differences in recommendation when considering health and risk factor measures. Research is needed to understand differences in recommendation and adherence. Greater encouragement and follow-through may be needed for groups less likely to adhere.

KEY WORDS: Colorectal cancer, Sigmoidoscopy, Colonoscopy, .