title: Identifying opportunities for improved colorectal cancer screening in primary care.
abstract: BACKGROUND
  Although current recommendations advocate screening persons 50 years of age or older for colorectal cancer (CRC), actual screening practice is highly variable among primary care physicians (PCPs). Knowledge of the factors that influence whether or not screening is offered during a clinic visit is essential to develop effective screening strategies.
  
  
  METHODS
  A cross-sectional telephone survey of one in four randomly selected patients aged 50 years or older (n = 400) attending a primary care clinic within an integrated health care system in central Texas was conducted. A survey of all PCPs (n = 32) at the practice sites was also administered.
  
  
  RESULTS
  The visit type was an important determinant of whether CRC screening was discussed, with most discussion occurring during visits for physicals (P < 0.0001). This finding was corroborated by the physician survey. Patient age and education were also associated with a higher likelihood of having been offered CRC screening (P = 0.009 and 0.014, respectively). Patient race, gender, primary language, PCP, or clinics attended were not significantly associated with the discussion of CRC screening.
  
  
  CONCLUSIONS
  Discussions regarding CRC screening are most likely to occur during preventive care visits. Thus, facilitating preventive visits especially for the elderly represents an opportunity to improve CRC screening rates in primary care practice.
authors.affiliation: Department of Family & Community Medicine, Scott & White Clinic, Texas A&M University System Health Science Center College of Medicine, Temple, TX 76508, USA. ppatel@swmail.sw.org
authors.forename: Parita
authors.initials: P
authors.lastname: Patel
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Forjuoh
authors.forename: Andrejs
authors.initials: A
authors.lastname: Avots-Avotins
authors.forename: Tushar
authors.initials: T
authors.lastname: Patel
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000592:standards*; D008875:Middle Aged; D010820:Physicians; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013781:Texas