Strategy of Offering Choice of CRC Screening Ups Adherence

Significant variation noted in overall and strategy-specific adherence between racial/ethnic groups

TUESDAY, April 10 (HealthDay News) -- Adherence to colorectal cancer (CRC) screening varies based on the screening strategy, with adherence linked to patient preference and ethnicity/race, according to a study published in the April 9 issue of the Archives of Internal Medicine.

To investigate whether the approach by which screening is recommended influences adherence, John M. Inadomi, M.D., from the University of Washington in Seattle, and colleagues randomly allocated 997 individuals at average risk for development of CRC to receive recommendations for screening. Recommendations were received for fecal occult blood testing (FOBT), colonoscopy, or the patient's choice of FOBT or colonoscopy. The completion of screening within 12 months was assessed as the primary outcome.

The researchers found that 58 percent of participants completed the screening strategy they were assigned to or chose. Screening was completed by 38 percent of those who were recommended to colonoscopy, compared with 67 percent of those recommended to FOBT (P < 0.001) and 69 percent of those given a choice (P < 0.001). Screening was completed significantly more often by Latinos and Asians (primarily Chinese) compared with African-Americans. White participants adhered to colonoscopy more often and nonwhite participants adhered to FOBT more often.

"The common practice of universally recommending colonoscopy may reduce adherence to CRC screening, especially among racial/ethnic minorities," the authors write. "These results suggest that patient preferences should be considered when making CRC screening recommendations."

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