Ontario Physicians More Likely to Get Colonoscopy Than Their Patients

Douglas K. Rex, MD, FASGE reviewing Litwin O, et al. Gastroenterology 2019 Oct 31.

This study evaluated administrative health care data from Ontario, Canada, to determine colorectal cancer screening rates among physicians, aged 52 to 74 years, and their patients. The goal was to determine if physicians who had undergone screening had patients who were more likely to have undergone screening. Up to date with screening included a fecal occult blood test (FOBT) within 2 years, flexible sigmoidoscopy within 5 years, or colonoscopy within 10 years. There were 11,434 physicians and 45,736 matched nonphysicians in the study. 

Uptake of colorectal tests was 67.9% in physicians and 66.6% in matched nonphysicians. Thus, physicians were not more likely to have been screened, though there was an age effect in which physicians in the 52- to 59-year age group were 4.7% more likely to have been screened and physicians in the 70- to 74-year age group were 4.4% less likely to have been screened. 

Physicians were less likely to undergo fecal blood testing (prevalence ratio, 0.44) and more likely to undergo colonoscopy (prevalence ratio, 1.24).

For family physicians, it was clear that those who had been screened had higher screening rates among their patients (adjusted prevalence ratio, 1.1). Further, their patients were more likely to have the same test that the physician had undergone, with a prevalence ratio of 1.27 for patients of physicians who had undergone FOBT and 1.22 among patients of physicians who had undergone colonoscopy.

These data indicate that physicians have a greater preference for colonoscopy as a screening test than do their patients. Further, convincing physicians to undergo screening themselves may be an effective method to increase nonphysician adherence.
Note to readers:
At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, FASGE
Bio and Disclosures

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Litwin O, Sontrop JM, McArthur E, et al. Uptake of colorectal cancer screening by physicians is associated with greater uptake by their patients. Gastroenterology 2019 Oct 31. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2019.10.027)