title: Colorectal cancer screening compliance and contemplation in gynecology patients.
abstract: OBJECTIVE
  Colorectal cancer screening (CRCS) should be a necessary part of gynecology (GYN) providers' preventive practices. The purpose of our study is to examine CRCS recommendations and adherence in this population.
  
  
  METHODS
  A questionnaire was administered to a prospective cohort of patients awaiting health maintenance exams at six academic and private gynecology offices. Patients reported demographics, CRC/breast/cervical screening adherence, CRCS recommendations, and future likelihood of CRCS.
  
  
  RESULTS
  A total of 461 women aged 51 years and older completed the questionnaire. Sixty-six percent of respondents were compliant with CRCS compared to 93% and 86% for breast and cervical cancer screening, respectively (p < 0.001). GYN providers recommended CRCS in 43% of patients. Sixty-three percent were planning to undergo future CRCS. On multivariable analysis, characteristics associated with CRCS adherence included (odds ratio, 95% confidence interval): older age (1.1 per year, 1.1-1.2), previous mammography (3.7, 1.4-9.7), family history (FH) of CRC/polyps (1.9, 1.0-3.4), friend with CRC (2.6, 1.5-4.7), and any doctor recommending CRCS (8.2, 4.6-14.7). CRCS rates were higher among patients who received a recommendation from a PCP (primary care provider) than from a GYN provider. Factors associated with intention to undergo CRCS include previous mammography (1.4, 4.2-12.0), any doctor recommendation (6.4, 3.7-11.0), and FH of CRC/polyps (3.5, 1.9-6.3). CRCS recommendations by both GYNs and PCPs had a greater impact on CRCS contemplation than those from a PCP or GYN alone.
  
  
  CONCLUSIONS
  In gynecology patients, having multiple providers recommend CRCS increases the likelihood of patients' intentions to undergo CRCS. However, CRCS compliance is primarily driven solely by PCP recommendations. Regardless, strategies must be in place to prompt gynecologists and nurse practitioners to discuss CRCS in eligible patients.
authors.affiliation: Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA. sbartnik@med.umich.edu
authors.forename: Stacy B
authors.initials: SB
authors.lastname: Menees
authors.forename: John
authors.initials: J
authors.lastname: Inadomi
authors.forename: Grace
authors.initials: G
authors.lastname: Elta
authors.forename: Sheryl
authors.initials: S
authors.lastname: Korsnes
authors.forename: Margaret
authors.initials: M
authors.lastname: Punch
authors.forename: Leslie
authors.initials: L
authors.lastname: Aldrich
mesh_terms: D001294:Attitude to Health; D003113:Colonoscopy / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D033182:Intention; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance