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Showing content from https://pubmed.ncbi.nlm.nih.gov/38235211/ below:

Engaging primary care physicians is critical in the screening and diagnosis of colorectal cancer at safety-net hospital systems

doi: 10.1016/j.sopen.2023.12.001. eCollection 2024 Jan. Engaging primary care physicians is critical in the screening and diagnosis of colorectal cancer at safety-net hospital systems

Affiliations

¹ Department of Surgery, Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
² Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

PMID: 38235211
PMCID: PMC10792257
DOI: 10.1016/j.sopen.2023.12.001

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Engaging primary care physicians is critical in the screening and diagnosis of colorectal cancer at safety-net hospital systems

Katrina Dimaano et al. Surg Open Sci. 2023.

doi: 10.1016/j.sopen.2023.12.001. eCollection 2024 Jan. Affiliations

¹ Department of Surgery, Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
² Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

PMID: 38235211
PMCID: PMC10792257
DOI: 10.1016/j.sopen.2023.12.001

Item in Clipboard

Abstract

Background: Primary care physicians (PCP) play a key role in offering colorectal cancer (CRC) screenings, particularly amongst underserved populations. Given potential delays in or omission of CRC screening in the absence of a PCP, we aimed to determine stage of CRC at diagnosis in an underserved population.

Methods: A retrospective chart review was conducted at two Los Angeles County safety-net hospitals. Inclusion criteria were a CRC diagnosis between 2018 and 2021 and age between 50 and 75 years at diagnosis time. The primary outcome was the cancer stage at diagnosis.

Results: A total of 373 patients were included, of those, 52.5 % had a PCP. Compared to others, PCP was similar in age, racial composition, and primary spoken language (Table 1). Of patients with a PCP, 52.0% were diagnosed by screening. After screening, the most common indication for colonoscopy were blood per rectum (24.9 %) and imaging findings (18.0 %). Patients with a PCP had a significantly lower rate of late stage CRC than those without a PCP (42.4 % vs. 68.0 %, p < 0.001). After adjustment, having a PCP was associated with significantly reduced odds of late stage CRC (Adjusted Odds Ratio 0.83, 95 % Confidence Interval [0.68-1.04]). Having a PCP was not associated with any adjusted increase in number of adenomas or tumor size.

Conclusions: Patients with a PCP, irrespective of undergoing screening, were diagnosed at earlier CRC stages. This underlines the crucial role of PCPs in CRC and diagnosis, reinforcing the need for their active involvement in these processes.

Keywords: Colorectal Cancer; Primary care physician; Screening.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures
Fig. 1

CONSORT diagram of study population.

Fig. 1

CONSORT diagram of study population.

Fig. 1

CONSORT diagram of study population.