1A-4 INFLUENCES ON PRIMARY CARE PROVIDERS' RECOMMENDATIONS FOR HYPOTHETICAL PROSTATE AND COLON CANCER SCREENING IN OLDER ADULTS: A WITHIN-SUBJECTS EXPERIMENT

Monday, October 19, 2015: 1:45 PM
Grand Ballroom A (Hyatt Regency St. Louis at the Arch)

Christine E. Kistler, MD, MASc, Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, Maihan Vu, DrPH, MPH, Center for Health Promotion and Disease Prevention. The University of North Carolina at Chapel Hill, Chapel Hill, NC, Anne Sutkowi-Hemstreet, Community Programs, Napa County Office of Education, Napa, CA, Ziya Gizlice, PhD, Biostatistical Support Unit, Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, NC, Carmen Lewis, MD, MPH, Dividsion of General Internal Medicine, Department of Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO, Carol E. Golin, MD, Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, Russell Harris, MD, MPH, Cecil G. Sheps Center for Health Services Research,University of North Carolina at Chapel Hill, Chapel Hill, NC, Noel T. Brewer, PhD, Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, Emily Elstad, PhD, American Institutes for Research (AIR), Chapel Hill, NC, Rowena Dolor, MD, MSH, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, Colleen Barclay, Sheps Center for Health Services Research, University of North Carolina Chapel Hill, Chapel Hill, NC and Stacey Sheridan, MD, MPH, Division of General Medicine and Clinical Epidemiology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC

Title: Influences on Primary Care Providers' Recommendations for Hypothetical Prostate and Colon Cancer Screening in Older Adults: a Within-subjects Experiment

 

Abstract (word count max 375)- currently 283

 

Purpose:    To identify factors that influence primary care providers' recommendations for cancer screening in older adults.

 

Methods:    A cross-sectional survey of all primary care providers (n=123) in a Research Consortium of 24 primary care Family Medicine and General Internal Medicine clinics in central North Carolina. We designed a within-subjects experiment in which providers read two hypothetical patient vignettes that varied by type of cancer screening test (prostate and colorectal) and were asked whether they would recommend screening for patients that varied by age (age 50, 70, 90) and request for screening (request and no request).  Outcomes were providers' recommendations for cancer screening.

 

Results:   We found 51% (95% CI 48%, 54%) would recommend cancer screening, regardless of screening test type, patient age, or patient request.  Providers reported they would recommend screening more often for colorectal cancer as compared to prostate cancer (p<0.001) and for younger patients as compared to older patients (p>0.001) Providers said they would recommend screening more often when the patient requested it as compared to when patients made no request for screening, for both vignettes (prostate and colorectal cancer screening) across all ages (p<0.001).  The recommendation for screening of hypothetical younger patients was more pronounced for colorectal cancer screening as compared to prostate cancer screening (p<0.001 for the interaction of age on the relationship between screening test and recommendation).  The interaction of age on the relationship between patient request and recommendation approached statistical significance (p=0.08).

Conclusions: Providers' reported recommendations for cancer screening depended on type of hypothetical patient being screened. Colorectal cancer screening, younger age, and patient request all increased providers' recommendations. Next steps may include the development of interventions to address screening for prostate cancer, older adults, or patient request.

See more of: ORAL ABSTRACTS: PREFERENCES AND DECISION MAKING IN COLORECTAL CANCER SCREENING

See more of: 37th Annual Meeting of the Society for Medical Decision Making