Patients see, patients do: CRC screening uptake better when physicians themselves get tested

A physician’s screening practices may affect their patients’, with the latter more likely to undergo colorectal cancer (CRC) screening if their physician has been tested, a new study has found.

Accessing administrative databases, researchers analysed data of 11,434 physicians and 45,736 matched non-physicians, all of whom were 52–74 years of age and were at average risk of CRC. Screening uptake was defined as having a record of faecal occult blood test in the past 2 years, flexible sigmoidoscopy in the past 5 years or colonoscopy in the past 10 years.

In the enrolled physicians, the uptake of CRC screening was 67.9 percent, only slightly but significantly higher than the 66.6 percent uptake rate in matched non-physicians (prevalence ratio, 1.02, 95 percent confidence interval [CI], 1.00–1.03; p=0.01).

Specifically, while physicians were significantly more likely to undergo colonoscopy (prevalence ratio, 1.24, 95 percent CI, 1.22–1.26), they were much less likely to receive faecal occult blood testing (prevalence ratio, 0.44, 95 percent CI, 0.42–0.47).

Using billing claim frequency data, the researchers then matched patients to family physicians. This revealed that patients were significantly more likely to have undergone CRC testing if their doctor had done so as well (prevalence ratio, 1.10, 95 percent CI, 1.08–1.12).

Disaggregation according to the specific test showed a consistently strong effect of physician testing uptake: faecal occult blood test (prevalence ratio, 1.27, 95 percent CI, 1.21–1.33) and colonoscopy (prevalence ratio, 1.22, 95 percent CI, 1.20–1.25).