Comorbidities may affect screening modality, but many docs recommend non-beneficial screening
MONDAY, June 11 (HealthDay News) -- A substantial portion of primary care physicians (PCPs) recommend screening elderly patients with advanced cancer for colorectal cancer (CRC), according to a study published online June 1 in the Journal of General Internal Medicine.
David A. Haggstrom, M.D., from the VA Medical Center in Indianapolis, and colleagues analyzed survey results from 1,266 PCPs (internal medicine, family practice, and obstetrics-gynecology physicians). Physician CRC screening recommendations were assessed based upon clinical vignettes.
The researchers found that 25 percent of PCPs recommended CRC screening for an 80-year-old patient with unresectable non-small-cell lung cancer (NSCLC). Obstetrician-gynecologists were more likely to recommend CRC screening for these patients, while physicians with a full electronic medical record were less likely to do so. Seventy-one percent of PCPs recommended CRC screening for an 80-year-old patient with ischemic cardiomyopathy (New York Heart Association, Class II). Fecal occult blood testing (FOBT) was recommended as the preferred screening modality rather than colonoscopy for 19 percent of healthy 80-year-olds, 5 percent of healthy 50-year-olds, and 2 percent of healthy 65-year-olds.
"PCPs consider comorbidity when screening older patients for CRC and may change the screening modality from colonoscopy to FOBT. However, a sizable proportion of PCPs would recommend screening for patients with advanced cancer who would not benefit," the authors write.
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