Survey of internal medicine residents' use of the fecal occult blood test and their understanding of colorectal cancer screening and surveillance

Virender K. Sharma, Fred A. Corder, Jean Pierre Raufman, Prateek Sharma, M (Brian) Fennerty, Colin W. Howden

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

OBJECTIVE: Primary care physicians have imperfect understanding of current colorectal cancer screening guidelines and recommendations. Furthermore, compliance with colorectal cancer screening by internal medicine residents has been demonstrated to be poor. We sought to identify whether current trainees in internal medicine had adequate understanding of colorectal cancer screening and surveillance and test utilization. METHODS: We applied a structured questionnaire about colorectal cancer screening and the use of fecal occult blood tests to 168 internal medicine residents at four accredited programs in the U.S. They were also asked for recommendations about six hypothetical patients who may have been candidates for screening or surveillance. RESULTS: Seventy-one percent identified 50 yr as the currently recommended age to commence screening in an average-risk individual; 64.3% would begin screening with fecal occult blood testing and flexible sigmoidoscopy and 4.8% with colonoscopy. Most perform fecal occult blood testing on stool obtained at digital rectal exam and without prior dietary restrictions. Many use fecal occult blood testing for indications other than colorectal cancer screening. Only 29% recommended colonoscopy to evaluate a positive fecal occult blood test. Most residents plan to be screened for colorectal neoplasia at the appropriate age; significantly more opted for colonoscopy than recommended it for their patients. CONCLUSIONS: Internal medicine residents have many misperceptions regarding colorectal cancer screening and the utility of the fecal occult blood test. Educational efforts should be directed at internal medicine residents, many of whom plan careers in primary care, where most colorectal cancer screening is currently performed. (C) 2000 by Am. Coll. of Gastroenterology.

Original languageEnglish (US)
Pages (from-to)2068-2073
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume95
Issue number8
DOIs
StatePublished - 2000
Externally publishedYes

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Occult Blood
Hematologic Tests
Internal Medicine
Early Detection of Cancer
Colorectal Neoplasms
Colonoscopy
Sigmoidoscopy
Primary Care Physicians
Gastroenterology
Surveys and Questionnaires
Primary Health Care
Guidelines

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Survey of internal medicine residents' use of the fecal occult blood test and their understanding of colorectal cancer screening and surveillance. / Sharma, Virender K.; Corder, Fred A.; Raufman, Jean Pierre; Sharma, Prateek; Fennerty, M (Brian); Howden, Colin W.

In: American Journal of Gastroenterology, Vol. 95, No. 8, 2000, p. 2068-2073.

Research output: Contribution to journalArticle

Sharma, Virender K. ; Corder, Fred A. ; Raufman, Jean Pierre ; Sharma, Prateek ; Fennerty, M (Brian) ; Howden, Colin W. / Survey of internal medicine residents' use of the fecal occult blood test and their understanding of colorectal cancer screening and surveillance. In: American Journal of Gastroenterology. 2000 ; Vol. 95, No. 8. pp. 2068-2073.
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abstract = "OBJECTIVE: Primary care physicians have imperfect understanding of current colorectal cancer screening guidelines and recommendations. Furthermore, compliance with colorectal cancer screening by internal medicine residents has been demonstrated to be poor. We sought to identify whether current trainees in internal medicine had adequate understanding of colorectal cancer screening and surveillance and test utilization. METHODS: We applied a structured questionnaire about colorectal cancer screening and the use of fecal occult blood tests to 168 internal medicine residents at four accredited programs in the U.S. They were also asked for recommendations about six hypothetical patients who may have been candidates for screening or surveillance. RESULTS: Seventy-one percent identified 50 yr as the currently recommended age to commence screening in an average-risk individual; 64.3{\%} would begin screening with fecal occult blood testing and flexible sigmoidoscopy and 4.8{\%} with colonoscopy. Most perform fecal occult blood testing on stool obtained at digital rectal exam and without prior dietary restrictions. Many use fecal occult blood testing for indications other than colorectal cancer screening. Only 29{\%} recommended colonoscopy to evaluate a positive fecal occult blood test. Most residents plan to be screened for colorectal neoplasia at the appropriate age; significantly more opted for colonoscopy than recommended it for their patients. CONCLUSIONS: Internal medicine residents have many misperceptions regarding colorectal cancer screening and the utility of the fecal occult blood test. Educational efforts should be directed at internal medicine residents, many of whom plan careers in primary care, where most colorectal cancer screening is currently performed. (C) 2000 by Am. Coll. of Gastroenterology.",
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