NEW YORK (Reuters Health) - Many older Americans are not up-to-date with their colorectal cancer screening exams, report researchers from the U.S. Centers for Disease Control and Prevention, Atlanta.
And primary care doctors may bear some responsibility, Zahava Berkowitz and colleagues at the CDC say. They found that not receiving a doctor's recommendation to get screened for colorectal cancer was one of the most common reasons cited for not getting tested.
Both the US Preventive Services Task Force and the American Cancer Society recommend regular colorectal cancer screening for people 50 and older, with an in-home test for blood in the stool performed annually; a flexible sigmoidoscopy or barium enema every five years; or a colonoscopy every 10 years.
Stopping screening for colon cancer could be warranted in some people with a "limited life expectancy," the researchers note in their report, but people 65 and older also face the greatest risk of colorectal cancer, and life expectancy among older people is increasing.
To investigate older people's knowledge of and attitudes toward colorectal cancer screening, Berkowitz and her team surveyed 1,148 men and women aged 65 to 89 with no history of colorectal cancer.
They found that 42 percent were not up-to-date with recommended screenings. One-quarter of those surveyed hadn't heard of the fecal occult blood test, while 17 percent had never heard of sigmoidoscopy or colonoscopy.
Among people who weren't up-to-date, more than 75 percent said their doctor hadn't recommended that they get screened.
Past research has found gaps in primary care physicians' knowledge about appropriate colorectal cancer screening, Berkowitz told Reuters Health; while one survey found 98 percent of doctors said they recommended it to their patients, some didn't know when screening should begin or how frequently it should be done.
"When the findings from this survey were combined with data from a national health survey of the general population to identify barriers to colorectal cancer screening, primary care physicians identified patient-related factors, such as anxiety or embarrassment and lack of awareness of the importance of screening by patients as the main barriers to screening," Berkowitz said. "However, very few adults aged 50 years and older reported anxiety or embarrassment as barriers to colorectal cancer screening."
