title: Colorectal cancer screening of African Americans by internal medicine resident physicians can be improved with focused educational efforts.
abstract: Colorectal cancer causes significant morbidity and mortality in the United States. African Americans are disproportionately affected by this malignancy. There is evidence to suggest that resident physicians inconsistently screen for colorectal cancer in African Americans, perhaps because of a deficiency in knowledge and limited resources. This study evaluated internal medicine resident physicians' colorectal screening practices in African Americans prior to and following a focused educational intervention. A medical record review of internal medicine resident physicians' adherence to colorectal cancer screening recommendations was conducted. Physicians' performance of rectal exams, fecal occult blood testing, flexible sigmoidoscopy and colonoscopy was evaluated for six months prior to and six months following an educational intervention that focused upon issues related to racial disparities in colorectal cancer. Statistical significance was assessed using Fischer's exact test. There were 116 patients included in the preintervention assessment and 132 patients included in the postintervention assessment. There was no statistical significance in the rate at which rectal exams (p=0.6605) and fecal occult blood testing (p=0.7748) were performed prior to and following the educational initiative. However, there was a statistically significant difference in the rate at which endoscopic assessments (p<0.0001) were performed. Educational interventions that are focused upon racial disparity in colorectal cancer may improve resident physicians' performance of endoscopic exams in African Americans. Continued effort to enhance resident physicians' colorectal cancer screening practices in African Americans is important.
authors.affiliation: Division of Gastroenterology and Liver Diseases, George Washington University, Washington, DC 20037, USA. mark425@gwu.edu
authors.forename: Mark
authors.initials: M
authors.lastname: Friedman
authors.forename: Marie L
authors.initials: ML
authors.lastname: Borum
mesh_terms: D001741:Black or African American; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D004522:Educational Status; D019983:Guideline Adherence; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000592:standards; D007396:Internship and Residency; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology