Intraurban influences on physician colorectal cancer screening practices.
BACKGROUND
Community social and economic resources influence colorectal (CRC) screening decisions by physicians and patients. The aim of this study is to systematically assess the differences in screening recommendations of primary care physicians within two urban communities that are distinct in socioeconomic characteristics.


METHODS
Two-hundred-sixty-four primary care community (i.e., not hospital-based) physicians were stratified by community. Using self-report questionnaires, we examined primary care physicians' CRC screening practices, knowledge of risk factors and perceived physician and patient barriers to screening, Physicians practicing in upper-socioeconomic status (SES) communities were compared with those of participants practicing in lower SES communities.


RESULTS
Physicians practicing in low-SES urban communities were significantly more likely to screen with fecal occult blood test than were physicians in upper-SES areas. Alternatively, upper-SES physicians were significantly more likely to recommend screening colonoscopy than were lower-SES physicians. The number of physicians (N=11) who screened for CRC using the double-contrast barium enema were few.


CONCLUSIONS
Community-level SES influences physician cancer screening practices. Further understanding of these relationships may guide the development of interventions targeted to specific neighborhoods within urban areas.
Gorin
Sherri Sheinfeld
SS
Department of Health and Social Behavior, Columbia University, New York, NY 10027, USA. ssg19@columbia.edu
Ashford
Alfred R
AR
Lantigua
Rafael
R
Hajiani
Farida
F
Franco
Rebeca
R
Heck
Julia E
JE
Gemson
Donald
D
D000328:Adult; D001741:Black or African American; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D003153:Community Health Services; D003469:Culture; D005260:Female; D019538:Health Care Surveys; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009518:New York; D010820:Physicians / Q000523:psychology*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population