Colorectal cancer screening rates low in Canada three years after guidelines issued
Monday, 29 November 1999 19:00 | 
| Medicexchange News - Medicexchange News |
In Canada, three years after the publication of national guidelines advocating colorectal cancer (CRC) screening for average risk adults aged 50 to 74 years, rates of screening ""were very low,"" a survey found.
"Public education programs and primary care interventions to specifically invite average risk adults for screening may be required to increase CRC screening rates," conclude Dr. S. Elizabeth McGregor of the Alberta Cancer Board, Calgary and colleagues in the August issue of the American Journal of Gastroenterology.
In a telephone survey, they assessed colorectal cancer awareness and screening rates among 1,808 Alberta men and women between 50 and 74 years of age. Results showed that 58.1 per cent of average-risk adults (n = 1,476) were aware of the home fecal occult blood test (FOBT) and 81.8 per cent were aware of sigmoidoscopy and/or colonoscopy.
Overall, only 14.3 per cent of average-risk adults were up-to-date on CRC screening and only three per cent had undergone screening endoscopy within the past five years, the authors report.
More average-risk women than men reported a recent home FOBT (14.0 vs. 9.8 per cent), but men had slightly higher rates of screening endoscopy in the past five years (4.3 vs. 1.6 per cent).
A physician's recommendation to undergo CRC screening was the strongest predictor of screening for both men (OR, 5.0) and women (OR, 3.8), yet the majority of men and women had not received such a recommendation from their physician, Dr. McGregor and colleagues found. Only 13.2 per cent of average-risk adults reported a doctor recommendation for CRC screening.
"The prevalence of CRC screening is not what it needs to be," Dr. Linda Rabeneck of the University of Toronto notes in an editorial. "We need to systematically evaluate interventions to increase screening adherence, identify predictors of screening uptake, and identify reasons for nonadherence.
"Public education programs and primary care interventions to specifically invite average risk adults for screening may be required to increase CRC screening rates," conclude Dr. S. Elizabeth McGregor of the Alberta Cancer Board, Calgary and colleagues in the August issue of the American Journal of Gastroenterology.
In a telephone survey, they assessed colorectal cancer awareness and screening rates among 1,808 Alberta men and women between 50 and 74 years of age. Results showed that 58.1 per cent of average-risk adults (n = 1,476) were aware of the home fecal occult blood test (FOBT) and 81.8 per cent were aware of sigmoidoscopy and/or colonoscopy.
Overall, only 14.3 per cent of average-risk adults were up-to-date on CRC screening and only three per cent had undergone screening endoscopy within the past five years, the authors report.
More average-risk women than men reported a recent home FOBT (14.0 vs. 9.8 per cent), but men had slightly higher rates of screening endoscopy in the past five years (4.3 vs. 1.6 per cent).
A physician's recommendation to undergo CRC screening was the strongest predictor of screening for both men (OR, 5.0) and women (OR, 3.8), yet the majority of men and women had not received such a recommendation from their physician, Dr. McGregor and colleagues found. Only 13.2 per cent of average-risk adults reported a doctor recommendation for CRC screening.
"The prevalence of CRC screening is not what it needs to be," Dr. Linda Rabeneck of the University of Toronto notes in an editorial. "We need to systematically evaluate interventions to increase screening adherence, identify predictors of screening uptake, and identify reasons for nonadherence.
