National Surveys of Colorectal Cancer Screening Policies & Practices:
Physician Recommendations for Follow-Up of Positive Fecal Occult Blood Tests
Abstract: Following a positive fecal occult blood test (FOBT),
physician recommendation of complete diagnostic evaluation (CDE) is an important first
step to ensure identification and treatment of preinvasive or invasive colorectal cancer.
Physicians may not recommend CDE, however, potentially compromising the effectiveness of
colorectal cancer screening programs and the quality of care for individual patients. The
authors used a theoretical model of health behavior and two national physician samples to
explore factors associated with recommendations for CDE. Overall, 63 percent of the sample
of physicians providing primary care and 76 percent of the gastroenterologist and general
surgeon sample reported recommending CDE. Variables representing the theoretical model
constructs of physician background, experience, and practice patterns; practice
environment; physician psychosocial representations; and patient characteristics were
significantly associated with recommendations of CDE. Development of interventions to
improve recommendations of CDE is an important area for future research.
Reference: Yabroff KR, Klabunde CN, Myers R, Brown ML.
Physician recommendations for follow-up of positive fecal occult blood tests.
Med Care Res Rev 2005 Feb;62(1):79-110.
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