Survey results report a knowledge gap regarding early-onset CRC screening among PCPs
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Primary care practitioners need increased education and recommendations for early-onset colorectal cancer screening practices, according to a presentation at Digestive Disease Week.
“The burden of CRC in young patients is increasing; in an effort to address this changing epidemiology, multiple professional societies are considering recommendations to lower the starting age of CRC screening from 50 to 45 years old,” Anjali Parekh, MD, University of Colorado Anschutz Medical Campus, said. “PCPs are responsible for CRC risk assessment and make screening recommendations to patients, but there's limited data on PCPs knowledge and practices around early-onset CRC.”
In a multicenter study, researchers surveyed 723 PCP trainees and independent providers using a 44-item online evaluation to assess PCP’s knowledge of early-onset CRC and screening practices. Experts in CRC prevention assessed content validity and 17 gastroenterologists performed pilot testing.
Of 196 respondents, 78% reported awareness of rising early-onset CRC incidence and 43% reported awareness of rising early-onset CRC mortality. When surveyed about CRC screening practices for average risk patients, 92% recommended screening starting in patients aged 50 years, 87% reported never or rarely offering screening to patients aged 45 years to 49 years without a family history of CRC and only 51% reported consistently offering colonic evaluation to patients aged 40 years to 49 years with rectal bleeding. Further, while most respondents correctly identified multiple high-risk subgroups, African American race was not reported as a factor prompting early CRC screening. Of note, 64% of respondents reported convincing evidence of benefit would increase their likelihood of referring average risk patients under the age of 50 years for CRC screening.
“We have found that a significant knowledge gap exists, with the majority of PCPs unaware that mortality of early-onset CRC is increasing, and the vast majority of PCPs are not considering screening for average risk patients under the age of 50,” Parekh concluded. “Our results support continued education efforts for PCPs and trainees regarding patients at high risk for early-onset CRC including, but not limited to, those with rectal bleeding, family history of CRC, iron deficiency, anemia and African American race.”
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Parekh A, et al. Abstract 873. Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).
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