| Screening Message Recommendation | Physician Group | Total (n = 24) | Illustrative Quotations | |
|---|---|---|---|---|
| Low Screeners (n = 8) | High Screeners (n = 16) | |||
| Colonoscopy recommended, with colonoscopy offered secondarily | 4 (50.0) | 7 (43.8) | 11 (45.8) | “Well I tell them about doing a hemoccult test first, that that's the established way and very effective way to determine whether you should have a sigmoidoscopy or colonoscopy, if result is positive. And so we talk about that—the hemoccult test that they do at home; and the fact that if it shows blood, they need to have a complete visualization of their colon. But if there's not blood, they can just do the sigmoidoscopy.…And then there are also people who want a colonoscopy…. I'm not gonna argue with someone like that.” |
| FOBT, FS, colonoscopy all offered simultaneously and neutrally | 2 (25.0) | 9 (56.3) | 11 (45.8) | “Now, there's three different possibilities for screening. There's the sort of least, easiest, least invasive thing, but it has to be done every year, and that would be, um, doing, um, stool occult blood cards.…Um, the next option is a combination of doing the stool hemoccult. If they're positive you do a, um, colonoscopy; if they're negative then we do something called a “flexible sigmoidoscopy,' and this is actually the approach that Group Health recommends.…And then the other option is a colonoscopy, and that's the most invasive test, but it's also one that is only done every 10 years. And if it's normal, you don't have to do anything in between.” |
| Colonoscopy recommended as first step | 2 (25.0) | 0 (0) | 2 (8.3) | “I tell patients, “if you really wanna have the best test that you can have right now—that you know is more invasive, but it's better as far as ruling in or out any disease—you should have a colonoscopy. And if it is normal then you don't need to do anything for 10 years. That is the beauty of it. Whereas if you do the other tests you have to keep repeating them. And my view of that, “cause I used to do sigmoidoscopy, is I think that's a wasted step; you might as well go straight to colonoscopy.'” |
Values provided as n (%).
FOBT, fecal occult blood testing; FS, flexible sigmoidoscopy.