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Giving Patients a Screening Choice Matters

When patients  were offered a choice of colorectal cancer screening with either FOBT or colonoscopy, they were significantly more likely to complete that screening than when their doctors recommended only FOBT or only colonoscopy.

Nearly 1000 racially and ethnically diverse patients in urban primary care practices were randomly assigned to get colorectal cancer screening via:

  • Fecal occult blood testing (FOBT)
  • Colonoscopy, or
  • Their choice of either FOBT or colonoscopy.

Overall, 58 percent were screened within the next year. 

  • 67 percent of those offered an FOBT home test finished screening.
  • 38 percent of those who got a colonoscopy recommendation actually had the exam.
  • 69 percent of patients who had a choice were screened.

Non-whites were more likely to complete FOBT, while whites accepted colonoscopy more often. Latinos and Asians were more likely to complete screening than African Americans

John M. Inadomi, MD and his team concluded,

The common practice of universally recommending colonoscopy may reduce adherence to CRC screening, especially among racial/ethnic minorities. Significant variation in overall and strategy-specific adherence exists between racial/ethnic groups; however, this may be a proxy for health beliefs and/or language. These results suggest that patient preferences should be considered when making CRC screening recommendations.

SOURCE: Inadomi et al, Archives of Internal Medicine, Volume 172, Number 7, April 9, 2012.

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