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Frequency of colorectal cancer screening and the impact of family physicians on screening behaviour

From the Department of Epidemiology and Community Medicine (Zarychanski, Chen, Hébert), University of Ottawa, Ottawa, Ont.; the Ottawa Health Research Institute (Zarychanski, Hébert), Ottawa, Ont.; and the Department of Internal Medicine (Bernstein), University of Manitoba, Winnipeg, Man.

Correspondence to: Dr. Ryan Zarychanski, Ottawa Health Research Institute, 501 Smyth Rd., Ottawa ON K1H 8L6; ryan{at}zarychanski.com

Background: Mortality associated with colorectal cancer can be reduced by early detection. However, the participation of eligible people in colorectal cancer screening is thought to be inadequate. We examined the frequency of colorectal cancer screening in 4 Canadian provinces and the influence of patient contact with a family physician on the uptake of cancer screening.

Methods: We performed analyses using data from the 2003 Canadian Community Health Survey. The study population included 12 776 people at average risk for colon cancer living in British Columbia, Saskatchewan, Ontario, and Newfoundland and Labrador who were aged 50 years or older and who were eligible for colorectal cancer screening. We assessed the proportion of respondents who reported having previous colorectal cancer screening tests and the degree of contact with a family physician.

Results: The provincial response rates for the survey were 78.5%–87.0%. The proportion of respondents who reported any history of colorectal cancer screening was 23.5%. This value dropped to 17.6% when only up-to-date screening was considered (screening within the time frame recommended in guidelines). The proportion of people with up-to-date colorectal cancer screening varied significantly among provinces, but it was low in all provinces sampled. Contact with a family physician was associated with increased colorectal cancer screening. Compared with no physician contact, the odds of screening associated with 1–2 physician contacts in the 12 months before the survey was 1.97 (95% confidence interval [CI] 1.56–2.48], and the odds of screening associated with more than 4 contacts was 2.75 (95% CI 2.14–3.53).

Interpretation: Self-reported colorectal cancer screening falls well below acceptable levels. People with increased contact with a family physician are more likely than those without contact to report a history of up-to-date colorectal cancer screening.

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