Primary Care Provider Knowledge and Practice in Risk Assessment for Early Age Onset Colorectal Cancer: Opportunities for Improvement

Anjali Parekh; Camille J. Hochheimer; Jeannine M. Espinoza; Jordan J. Karlitz; Carmen L. Lewis; Sachin Wani; Swati G. Patel

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자료유형: 학술저널

저자정보: Anjali Parekh (University of Colorado Anschutz Medical Center) Camille J. Hochheimer (University of Colorado) Jeannine M. Espinoza (Denver Health Hospital Authority) Jordan J. Karlitz (University of Colorado) Carmen L. Lewis (University of Colorado) Sachin Wani (Rocky Mountain Regional Veterans Affairs Medical Center) Swati G. Patel (University of Colorado)

저널정보: 대한암예방학회 대한암예방학회지 대한암예방학회지 제26권 제4호

발행연도: 2021.12

수록면: 298 - 303 (6page)

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Colorectal cancer (CRC) incidence and mortality are rising in individuals under age 50, termed early age onset (EAO) CRC. Lower endoscopy is recommended for all patients with unexplained iron deficiency anemia (IDA) or hematochezia to assess the EAO CRC. For those without symptoms, professional societies recommend decreasing the age to start screening from 50 to 45. Primary care provider (PCP) knowledge and practices around EAO-CRC risk assessment and screening are unknown. We conducted a survey study in May, 2020 of multi-specialty PCPs from three large medical systems to assess PCP knowledge, risk stratification practices and barriers/facilitators they face to offer CRC screening in patients < 50. We conducted univariate analysis to assess factors associated with knowledge and diagnostic practices. Response rate was 27.7% (196/708). Although 77.6% of respondents were aware that EAO-CRC incidence is increasing, only 42.9% knew that EAO-CRC mortality is also increasing. Of note, 91.8% recommend starting average risk screening at age 50. For 40- to 49-year-old patients present with unexplained IDA or hematoche zia, 71.9% and 50.5% of respondents, respectively, recommend a diagnostic colonoscopy. Trainees were less likely to be aware of rising EAO-CRC mortality (odds ratio, 0.42; 95% CI, 0.21 to 0.82) and non-internal medicine providers were less likely to recom mend CRC screening in those with a first-degree relative with CRC (odds ratio, 0.82; 95% CI, 0.72 to 0.93). Ongoing education ef forts will be required to improve recognition and management of high-risk symptoms, particularly among non-internists and trainees. Key Words Colorectal neoplasms, Early detection of cancer, Gastrointestinal hemorrhage, Iron deficiencies, Primary health care

#Colorectal neoplasms #Early detection of cancer #Gastrointestinal hemorrhage #Iron deficiencies #Primary health care

참고문헌 (17)

참고문헌 신청

Siegel RL / 2020 / Colorectal cancer in the young : epidemiology, prevention, management / Am Soc Clin Oncol Educ Book 40:1~14

Siegel RL / 2020 / Colorectal cancer statistics, 2020 / CA Cancer J Clin 70:145~164

Siegel RL / 2017 / Colorectal cancer mortality rates in adults aged 20 to 54 years in the United States, 1970-2014 / JAMA 318:572~574

Patel SG / 2020 / Colorectal cancer in persons under age 50 : seeking causes and solutions / Gastrointest Endosc Clin N Am 30:441~455

Patel SG / 2021 / Early age onset colorectal cancer / Adv Cancer Res 151:1~37

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