Colorectal cancer screening by obstetrician-gynecologists.

OBJECTIVE

Our purpose was to evaluate colorectal screening practices among obstetrician-gynecologists.

STUDY

DESIGN

Retrospective chart review of patients > or =50 years old, of the Boston University Residency Program in Obstetrics and Gynecology for compliance with guidelines from The American College of Obstetricians and Gynecologists.

RESULTS

A total of 2038 encounters yielded 557 annual/health maintenance examination. Overall rates of screening were as follows: rectal examination, 43%; guaiac (single), 37%; fecal occult blood testing (x3), 1.6%; flexible sigmoidoscopy, 5.4%; and Papanicolaou test, 98%. Analysis by type of provider demonstrated a significant difference only of the medical student-resident combination offering sigmoidoscopy to 14.3% of patients versus 5.4% for other providers. A significant increase in overall screening since 1996 was demonstrated (P =.014). Among patients returning for care, screening frequency increased significantly only for the rectal examination.

CONCLUSION

Since the publication of Guidelines for Women's Health Care, by The American College of Obstetricians and Gynecologists in 1996, there has been an increase in colorectal cancer screening among obstetrician-gynecologists. However, flexible sigmoidoscopy and fecal occult blood testing, the most effective means of achieving mortality reduction, remain underutilized. To fully realize the preventability of colorectal cancers in women, we should apply flexible sigmoidoscopy and fetal occult blood testing with the same vigilance currently given to the Papanicolaou test.