IMPROVING COLORECTAL CANCER SCREENING BY OB/GYNS

描述：（申请人描述）适性结直肠癌（CRC）

DESCRIPTION: (Applicant's Description) Appropriate colorectal cancer (CRC) screening using fecal occult blood testing (FOBT) can substantially reduce CRC mortality. The goal of this proposal is to increase CRC screening for women who view an Obstetrician/Gynecologist (OB/GYN) as their primary care provider. Less than 20% of eligible persons submit annually to FOBT as recommended. OB/GYNs provide the majority of preventive health services to women. Up to 50% of women eligible for CRC screening view OB/GYNs as their source of primary care. Preliminary studies suggest that OB/GYNs promote CRC screening even less than other types of primary care provider. The factors influencing the provision of CRC screening by OB/GYNs and the utilization of CRC screening by women are poorly described. To better understand these determinants, we will first perform a population-based survey of women eligible for screening. In addition to utilization, this telephone survey will assess women's' knowledge, beliefs and attitudes regarding CRC and CRC screening. Survey information, coupled with other preliminary data from OB/GYNs and patients will guide the development of simple, broadly applicable, written educational tools intended to educate OB/GYNs and their patients about CRC and the importance of screening. To determine whether these targeted educational interventions can enhance CRC screening, we propose to randomize OB/GYN practices in the Jefferson Health System, and their patients, to either a patient-directed or physician-directed educational intervention. In a second phase we will study the effect of these two interventions together on CRC screening rates. OB/GYNs and their patients have never been a focus of such efforts. This provider group may represent an untapped resource to increase CRC screening. This proposal is an important extension of my previous studies on colorectal cancer risk for women, the use of FOBT for CRC screening, barriers to appropriate provision of CRC screening, and physician and patient educational interventions as a means to improve clinical outcomes. It represents a crucial component in my efforts to build a research career focused on gastrointestinal cancer prevention and control.