Colorectal cancer screening by primary care physicians in Texas: A rural-urban comparison

Background. Little is known about colorectal cancer (CRC) screening practices of primary care physicians (PCPs) in rural versus urban locations. Methods. The authors surveyed 3,380 PCP members of the Texas Medical Association (TMA), stratified by specialty and rural/urban status. Factors associated with PCPs' self-reported practices of CRC screening by fecal occult blood test (FOBT) and/or flexible sigmoidoscopy (SIG) were examined using chi-square tests and multivariate regression. Results. Over 80% of both rural and urban PCPs reported CRC screening with the FOBT, while 70% reported screening with SIG. Many reported doing FOBTs in the office versus using the take-home kit. Variations were found in recommended ages and screening intervals among all respondents. Conclusions. Geographic location was less important than knowledge and attitudes in predicting PCPs' CRC screening practices. More specific education regarding CRC screening guidelines needs to be directed towards all PCPs.