Variation in colorectal cancer testing between primary care physicians: a cross-sectional study in Switzerland

Alexander Leonhard Braun, Emanuele Prati, Yonas Martin, Charles Dvořák, Kali Tal, Nikola Biller-Andorno, Jean-Luc Bulliard, Jacques Cornuz, Kevin Selby and Reto Auer ()
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Alexander Leonhard Braun: University of Bern
Emanuele Prati: University of Bern
Yonas Martin: University of Bern
Charles Dvořák: President Sentinella Network
Kali Tal: University of Bern
Nikola Biller-Andorno: Institute for Biomedical Ethics and History of Medicine (IBME)
Jean-Luc Bulliard: University of Lausanne
Jacques Cornuz: University of Lausanne
Kevin Selby: University of Lausanne
Reto Auer: University of Bern

International Journal of Public Health, 2019, vol. 64, issue 7, No 12, 1075-1083

Abstract: Abstract Objectives To determine the proportion of 50–75-year-old patients who visit a primary care physician’s (PCP) office and were tested for colorectal cancer (CRC) by either colonoscopy within 10 years or fecal occult blood testing (FOBT) within 2 years. To describe the variation in care between PCPs and factors associated with these proportions. Methods Cross-sectional data collected between April and December 2017. Participants: PCPs reporting for the Swiss Sentinel Surveillance Network. Each PCP collected demographic data and CRC testing status from 40 consecutive patients. Measurements: proportions of patients up to date with CRC screening and method used (colonoscopy/FOBT/Other); variation in the outcome measures between PCPs; association of physician-level factors with main outcomes. Results 91/129 PCPs collected data from 3451 patients; 45% had been tested for CRC within recommended intervals (41% colonoscopy, 4% FOBT). The proportions of patients tested and testing with colonoscopy versus FOBT varied widely between PCPs. Language region was associated with PCPs’ rate of FOBT prescription. Conclusions Less than half of patients who visited PCPs in Switzerland were tested for CRC within recommended intervals. PCPs varied widely in their testing practices.

Keywords: Primary care; Colorectal cancer; Screening; Practice variation; Decision making (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s00038-019-01259-4

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