Doctors who are tested for colorectal cancer are more likely to screen their patients

Doctors who are up-to-date on their colorectal cancer screening are more likely to have patients who have also been tested for colorectal cancer, according to researchers at ICES, a non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. 

The researchers matched more than 11,000 physicians to more than 45,000 non-physicians in Ontario, of similar age, sex and residential location. 

They found that two-thirds of physicians were up-to-date on their colorectal cancer screening, which was the same as non-physicians. They also found primary care physicians who were up-to-date on their colorectal cancer screening were more likely to have patients who were also up-to-date on screening (69 per cent up-to-date vs. 62 per cent of patients were up-to-date when their physician was not up-to-date with their own screening).

“We found the rate of colorectal cancer screening was similar in physicians as non-physicians, and patients were more likely to be screened if their family doctor has been screened,” says Dr. Amit Garg, scientist at Lawson Health Research Institute, professor at Western University and site director of ICES Western.

Colorectal cancer screening increases the chance of finding cancer early, when it is easier to treat. When colorectal cancer is caught early, 9 out of 10 people can be cured. If you have colorectal cancer and do not get screened, you may miss the chance for early and more effective treatment.

According to Cancer Care Ontario recommendations, men and women 50 – 74 years of age at average risk of the disease should be screened for colorectal cancer using the fecal occult blood test (this was the gFOBT in the past, now it is the FIT). Those at increased risk because of a history of one or more first degree relatives (parent, brother or sister) diagnosed with the disease should be screened with colonoscopy. 

The researchers used the following approach to measure uptake of colorectal cancer testing:

• Fecal occult blood test in the past two years
• Flexible sigmoidoscopy in the past five years, or
• Colonoscopy in the past ten years

Physicians were less likely than non-physicians to undergo fecal occult blood testing and were more likely to undergo colonoscopy. 

“There is an opportunity for greater screening in physicians, who may in turn positively influence screening in their patients,” says Dr. Linda Rabeneck, an author on the study, vice-president, prevention & cancer control at Cancer Care Ontario and senior scientist at ICES. 

The study “Uptake of colorectal cancer screening by physicians is associated with greater uptake by their patients,” was published in Gastroenterology.

Author block: Litwin O, Sontrop JM, McArthur E, Tinmouth J, Rabeneck L, Vinden C, Sood MM, Baxter NN, Tanuseputro P, Welk B, Garg AX.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

ABOUT LAWSON HEALTH RESEARCH INSTITUTE: As the research institute of London Health Sciences Centre and St. Joseph’s Healthcare London, and working in partnership with Western University, Lawson Health Research Institute is committed to furthering scientific knowledge to advance healthcare around the world.

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