Variation in colorectal cancer testing between primary care physicians: a cross-sectional study in Switzerland.

OBJECTIVES

To determine the proportion of 50-75-year-old patients who visit a primary care physician's (PCP) office and were tested for colorectal cancer (CRC) by either colonoscopy within 10 years or fecal occult blood testing (FOBT) within 2 years. To describe the variation in care between PCPs and factors associated with these proportions.

METHODS

Cross-sectional data collected between April and December 2017.

PARTICIPANTS

PCPs reporting for the Swiss Sentinel Surveillance Network. Each PCP collected demographic data and CRC testing status from 40 consecutive patients.

MEASUREMENTS

proportions of patients up to date with CRC screening and method used (colonoscopy/FOBT/Other); variation in the outcome measures between PCPs; association of physician-level factors with main outcomes.

RESULTS

91/129 PCPs collected data from 3451 patients; 45% had been tested for CRC within recommended intervals (41% colonoscopy, 4% FOBT). The proportions of patients tested and testing with colonoscopy versus FOBT varied widely between PCPs. Language region was associated with PCPs' rate of FOBT prescription.

CONCLUSIONS

Less than half of patients who visited PCPs in Switzerland were tested for CRC within recommended intervals. PCPs varied widely in their testing practices.