title: Preferences for colorectal cancer screening tests and screening test use in a large multispecialty primary care practice.
abstract: BACKGROUND
  The purpose of this study was to identify factors associated with colorectal cancer (CRC) screening test preference and examine the association between test preference and test completed.
  
  
  METHODS
  Patients (n = 1224) were 50-70 years, at average CRC risk, and overdue for screening. Outcome variables were preference for fecal occult blood test (FOBT), colonoscopy (COL), sigmoidoscopy (SIG), or barium enema (BE), measured by telephone survey, and concordance between test preference and test completed assessed using medical records.
  
  
  RESULTS
  Thirty-five percent preferred FOBT, 41.1% COL, 12.7% SIG, and 5.7% BE. Preference for SIG or COL was associated with having a physician recommendation, greater screening readiness, test-specific self-efficacy, greater CRC worry, and perceived pros of screening. Preference for FOBT was associated with self-efficacy for doing FOBT. Participants who preferred COL were more likely to complete COL compared with those who preferred another test. Of those screened, only 50% received their preferred test. Those not receiving their preferred test most often received COL (52%).
  
  
  CONCLUSIONS
  Lack of concordance between patient preference and test completed suggests that patients' preferences are not well incorporated into screening discussions and test decisions, which could contribute to low screening uptake. Physicians should acknowledge patients' preferences when discussing test options and making recommendations, which may increase patients' receptivity to screening.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
authors.forename: Amy
authors.initials: A
authors.lastname: McQueen
authors.forename: L Kay
authors.initials: LK
authors.lastname: Bartholomew
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Greisinger
authors.forename: Sharon P
authors.initials: SP
authors.lastname: Coan
authors.forename: Ronald
authors.initials: R
authors.lastname: Myers
authors.forename: Sally W
authors.initials: SW
authors.lastname: Vernon
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009780:Occult Blood; D011320:Primary Health Care; D012812:Sigmoidoscopy