title: Colorectal cancer screening: physician recommendation is influential advice to Marylanders.
abstract: BACKGROUND
  In comparison to the United States, Maryland is facing a significantly higher burden of colorectal cancer incidence and mortality. The primary objective of this study was to determine the predictors of colorectal cancer screening use in Maryland.
  
  
  METHODS
  We performed secondary analyses on Maryland Cancer Survey 2002 data from 2994 respondents to investigate important predictors for individual colorectal cancer screening tests. CRC screening outcomes were defined as (1) FOBT within the past year, (2) sigmoidoscopy within the past 5 years, or (3) colonoscopy within the past 10 years.
  
  
  RESULTS
  We found that clinician recommendation for a screening test is the best predictor in both age categories (50-64 years and 65+ years); it is a very strong indicator and consistently improves the odds of use by a factor of at least 8 for any screening test.
  
  
  CONCLUSIONS
  There remains a great need for improved colorectal cancer screening in Maryland. According to our results, it is clear that the most influential way to improve overall colorectal cancer screening for each test and both age groups is to increase clinician recommendation for these tests.
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, MD 21205, USA. agilbert@jhsph.edu
authors.forename: Amy
authors.initials: A
authors.lastname: Gilbert
authors.forename: Norma
authors.initials: N
authors.lastname: Kanarek
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008396:Maryland; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D009780:Occult Blood; D010342:Patient Acceptance of Health Care; D010818:Practice Patterns, Physicians'; D012812:Sigmoidoscopy / Q000706:statistics & numerical data; D012959:Socioeconomic Factors