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.

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