Patients whose physicians recommend colonoscopy and those who follow through

Sunday, November 04, 2012



Background: More than half of eligible individuals are not up-to-date with colon cancer screening.

Purpose: To assess the characteristics of those who received a colonoscopy screening recommendation and those who followed the physician recommendation.

Methods: Patient self-administered questionnaire and medical record review in 16 private family physician practices.

Results: From 8372 patients invited to participate, 685 were enrolled and had a medical record review; 219 (32%) had a colonoscopy recommendation and 86 (39%) received a colonoscopy. Independent factors associated with having a recommendation for colonoscopy were significantly younger in age (odds ratios [OR] = 1.6), higher incomes (annual income ≥$40 000 vs <$40 000; OR = 1.8), physician or nurse discussion about colon cancer tests (OR = 1.6), physical visit in the preceding 26 months (OR = 1.7), distant relative with colon cancer (OR = 2.4), and a medical diagnosis of hyperlipidemia (OR = 2.1). Independent factors associated with following through on colonoscopy after a recommendation were age ≥65 years (OR = 0.3), male patient (OR = 0.4), and feeling that colon cancer screening is very important (OR = 3.2).

Conclusions: Socioeconomic factors are associated with receipt of a colonoscopy recommendation. Fewer than one third of patients had documentation of a physician colonoscopy recommendation and of those, less than half followed through.


Daly, J. M., Xu, Y., Levy, B. T. Patients whose physicians recommend colonoscopy and those who follow through. Journal of Primary Care and Community Health. First published online November 4, 2012 as doi: 10.1177/2150131912465314.

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