Primary Care Clinicians Tailor Colorectal Cancer Screening to Patients

Clinicians, both primary care clinicians (PCCs) and gastroenterologists (GIs), prefer colonoscopy for colorectal cancer (CRC) screening of average-risk patients, according to a study published online Dec. 14 in Mayo Clinic Proceedings.

Lila J. Finney Rutten, Ph.D., M.P.H., from the Mayo Clinic in Rochester, Minnesota, and colleagues assessed health care provider preferences related to CRC screening overall. An online survey was conducted Nov. 6 through Dec. 6, 2019, with responses from 779 PCCs and 159 GIs.

The researchers found that the majority of GIs chose colonoscopy for their preferred screening method (96.9 percent) versus 75.7 percent for PCCs. Among PCCs, 12.2 percent preferred screening using multitarget stool DNA (mt-sDNA), 7.3 percent preferred the fecal immunochemical test (FIT), and 4.8 percent preferred the guaiac-based fecal occult blood test (gFOBT). For patients who were unable to undergo invasive procedures, concerned about taking time from work, unconvinced about the need for screening, and who refused other screening recommendations, PCCs and GIs shifted preference toward noninvasive screening options. Preference for mt-sDNA over FIT and gFOBT was less frequent in PCCs in larger versus smaller clinical practices. Among PCCs with more years of clinical experience, higher patient volumes (>25/day), and practice locations in suburban and rural settings (compared with urban), preference for mt-sDNA over FIT was more likely.

"These findings suggest that primary care clinicians recognize the need to tailor their CRC screening recommendations to the preferences of their patients, especially with the emergence of new, less invasive options," a coauthor said in a statement.