title: The practices and attitudes of primary care nurse practitioners and physician assistants with respect to colorectal cancer screening.
abstract: OBJECTIVE
  Although nurse practitioners and physician assistants form a large and growing portion of the primary care workforce, little is known about their colorectal cancer screening practices. The aim of this study was to assess the colorectal cancer screening practices, training, and attitudes of nurse practitioners and physician assistants practicing primary care medicine.
  
  
  METHODS
  All nurse practitioners (827) and physician assistants (1178) licensed by the Medical Board of the State of North Carolina were surveyed by mail. Both groups were further divided into primary care versus non-primary care by self-described roles. Self-reported practices, training, and attitudes with respect to colorectal cancer screening were elicited.
  
  
  RESULTS
  Response rates were 71.4% and 61.2%, for nurse practitioners and physician assistants respectively. A total of 51.3% of nurse practitioners and 50.3% of physician assistants described themselves as adult primary care providers. No primary care nurse practitioners and only 3.8% of primary care physician assistants performed screening flexible sigmoidoscopy. However, 76% of primary care physician assistants and 69% of primary care nurse practitioners reported recommending screening flexible sigmoidoscopy. A total of 95% primary care physician assistants and 92% of primary care nurse practitioners reported performing fecal occult blood testing. Only 9.4% of physician assistants and 2.8% of nurse practitioners received any formal instruction in flexible sigmoidoscopy while in their training. Additionally, 41.4% of primary care physician assistants and 27.7% of primary care nurse practitioners reported that they would be interested in obtaining formal training in flexible sigmoidoscopy.
  
  
  CONCLUSIONS
  Physician assistants and nurse practitioners are motivated, willing and underutilized groups with respect to CRC screening. Efforts to increase education and training of these professionals may improve the availability of CRC screening modalities.
authors.affiliation: The School of Medicine, University of North Carolina, Chapel Hill, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Shaheen
authors.forename: M A
authors.initials: MA
authors.lastname: Crosby
authors.forename: M S
authors.initials: MS
authors.lastname: O'Malley
authors.forename: S C
authors.initials: SC
authors.lastname: Murray
authors.forename: R S
authors.initials: RS
authors.lastname: Sandler
authors.forename: J A
authors.initials: JA
authors.lastname: Galanko
authors.forename: D F
authors.initials: DF
authors.lastname: Ransohoff
authors.forename: J S
authors.initials: JS
authors.lastname: Klenzak
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009657:North Carolina; D009722:Nurse Practitioners / Q000523:psychology*; D009780:Occult Blood; D010823:Physician Assistants / Q000523:psychology*; D011320:Primary Health Care; D012812:Sigmoidoscopy