(HealthDay News) – A substantial portion of primary care physicians (PCPs) recommend screening elderly patients with advanced cancer for colorectal cancer (CRC).
David A. Haggstrom, MD, from the VA Medical Center in Indianapolis, and colleagues analyzed survey results from 1,266 PCPs (internal medicine, family practice, and obstetrics-gynecology physicians). Physician CRC screening recommendations were assessed based upon clinical vignettes.
The researchers found that 25% of PCPs recommended CRC screening for an 80 year-old patient with unresectable non-small-cell lung cancer (NSCLC). Obstetrician-gynecologists were more likely to recommend CRC screening for these patients, while physicians with a full electronic medical record were less likely to do so. Seventy-one percent of PCPs recommended CRC screening for an 80 year-old patient with ischemic cardiomyopathy (New York Heart Association, Class II). Fecal occult blood testing (FOBT) was recommended as the preferred screening modality rather than colonoscopy for 19% of healthy 80 year-olds, 5% of healthy 50 year-olds, and 2% of healthy 65 year-olds.
“PCPs consider comorbidity when screening older patients for CRC and may change the screening modality from colonoscopy to FOBT. However, a sizable proportion of PCPs would recommend screening for patients with advanced cancer who would not benefit,” the authors write.