title: Physician knowledge and appropriate utilization of computed tomographic colonography in colorectal cancer screening.
abstract: OBJECTIVE
  To assess physician understanding of computed tomographic colonography (CTC) in colorectal cancer (CRC) screening guidelines in a pilot study.
  
  
  BACKGROUND
  CTC is a sensitive and specific method of detecting colorectal polyps and cancer. However, several factors have limited its clinical availability, and CRC screening guidelines have issued conflicting recommendations.
  
  
  METHODS
  A web-based survey was administered to physicians at two institutions with and without routine CTC availability.
  
  
  RESULTS
  398 of 1655 (24%) participants completed the survey, 59% was from the institution with routine CTC availability, 52% self-identified as trainees, and 15% as gastroenterologists. 78% had no personal experience with CTC. Only 12% was aware of any current CRC screening guidelines that included CTC. In a multiple regression model, gastroenterologists had greater odds of being aware of guidelines (OR 3.49, CI 1.67-7.26), as did physicians with prior CTC experience (OR 4.81, CI 2.39-9.68), controlling for institution, level of training, sex, and practice type. Based on guidelines that recommend CTC, when given a clinical scenario, 96% of physicians was unable to select the appropriate follow-up after a CTC, which was unaffected by institution.
  
  
  CONCLUSIONS
  Most physicians have limited experience with CTC and are unaware of recent recommendations concerning CTC in CRC screening.
authors.affiliation: Muzzi Mirza Pancreatic Cancer Prevention and Genetics Program, Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Chang
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Shah
authors.forename: Sunil
authors.initials: S
authors.lastname: Amin
authors.forename: Susana
authors.initials: S
authors.lastname: Gonzalez
authors.forename: Joan C
authors.initials: JC
authors.lastname: Prowda
authors.forename: Joan M
authors.initials: JM
authors.lastname: Cheng
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Verna
authors.forename: Don C
authors.initials: DC
authors.lastname: Rockey
authors.forename: Harold
authors.initials: H
authors.lastname: Frucht
mesh_terms: D023881:Colonography, Computed Tomographic / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D019983:Guideline Adherence; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires