Preferences for Colorectal Cancer Screening Among Racially/Ethnically Diverse Primary Care Patients

Bibliographic Data

ID9101451
AuthorsSarah T Hawley (0000-0001-5756-645X, University of Michigan, corresponding author), Robert J Volk (0000-0001-8811-5854, Baylor College of Medicine), Partha Krishnamurthy (0000-0001-9061-0053, University of Houston), Maria Jibaja-Weiss, Maria Jibaja‐Weiss (0000-0003-4819-2243, Baylor College of Medicine), Sally W Vernon (0000-0002-4457-0625), Suzanne Kneuper (Baylor College of Medicine)
Year2008
Volume46
Issue9
PagesS10-S16
Publication date2008-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31817d932e
PMID18725820
OpenAlexW1964115671
LanguageEN
Citations received9
References cited34

BACKGROUND: Incorporating patients' preferences into colorectal cancer (CRC) screening recommendations has been identified as a potential mechanism for increasing adherence. This study used conjoint analysis to describe variation in CRC screening preferences among racially/ethnically diverse primary care patients. METHODS: We recruited patients ages 50-80 of a large practice-based research network stratified by white, African American, or Hispanic race/ethnicity to complete a preference assessment instrument. Participants were asked to rate 8 hypothetical CRC screening test scenarios comprised of different combinations of 5 attributes and 6 scenarios designed to depict guideline-recommended CRC screening tests (eg, fecal occult blood test, flexible sigmoidoscopy, colonoscopy, and double contrast barium enema) including new technology (eg, virtual colonoscopy, fecal immunochemical test). Responses were used to calculate the overall importance of test attributes, the relative importance of attribute levels, and to identify factors associated with preferences. RESULTS: Two hundred twelve primary care patients were recruited to the study (74 white, 60 African American, 78 Hispanic). Of the guideline-recommended tests, 37% preferred COL, 31% FOBT, 15% BE, and 9% SIG. Ratings of new technology tests were significantly (P < 0.05) higher than ratings of guideline-recommended tests. The order of the importance of attributes was: what the test involved (37%), accuracy (19%), frequency (17%), discomfort (15%), and preparation (13%). Part-worth utilities for 1 attribute showed that collecting a stool sample was most preferable and endoscopy without sedation least preferable. Multivariate regression found that race/ethnicity and specific test attributes were independently associated (P < 0.05) with test preferences. CONCLUSIONS: Primary care patients have distinct preferences for CRC screening tests that can be linked to test attributes. Racial/ethnic variations in test preferences persist when controlling for attributes. Tailoring screening recommendations to patients' preferences may increase screening adherence

Barium enema · Cancer · Colonoscopy · Colorectal cancer · Ethnic group · Family medicine · Fecal occult blood · Guideline · Pathology · Sigmoidoscopy · Test (biology) · Colorectal Cancer Screening and Detection · Colorectal Cancer Surgical Treatments · Global Cancer Incidence and Screening · Internal Medicine · Medicine

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