Related Experiment Video
Updated: Aug 11, 2026
Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
Colorectal cancer screening among the medically underserved
Michael S Wolf1, Melissa Satterlee, Elizabeth A Calhoun
1Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, USA. mswolf@northwestern.edu
Insights
Physician recommendations and completion rates for colorectal cancer screening remain low in Chicago
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Colorectal cancer screening is crucial for early detection and improved patient outcomes.
- Federally Qualified Health Centers (FQHCs) serve vulnerable, low-income populations, highlighting the need to assess screening practices within these settings.
- Understanding screening rates in underserved communities is vital for addressing health disparities.
Purpose of the Study:
- To investigate the prevalence of physician recommendations for colorectal cancer screening.
- To determine patient completion rates for recommended colorectal cancer screening.
- To examine factors associated with screening recommendations and completion in FQHCs.
Main Methods:
- Retrospective review of medical records from 3,416 primary care patients at 31 Chicago FQHCs.
- Identification of 642 eligible patients based on age and family history for colorectal cancer screening.
- Data collection on patient demographics, screening history, and physician recommendations.
Main Results:
- Physician screening recommendation rate was 9.2% (n=59); 7.0% (n=45) of eligible patients were appropriately screened.
- Fecal Occult Blood Test was the predominant screening method (94.1%).
- Patients receiving a physician recommendation had a high completion rate (76.2%); older patients were more likely to be recommended and screened.
Conclusions:
- Colorectal cancer screening rates are suboptimal in Chicago FQHCs, necessitating targeted interventions.
- Physician recommendation is a strong predictor of patient screening completion.
- Organizational support and interventions are required to enhance screening practices in medically underserved areas.
Abstract:
Prevalence of physician recommendation and patient completion of colorectal cancer screening was investigated among Federally Qualified Health Centers (FQHC) serving low-income neighborhoods in Chicago. Medical records of 3,416 patients receiving primary care services at 1 of 31 FQHCs were randomly chosen for review. In all, 642 patients were identified by age and family history as eligible for colorectal cancer screening and included in this study. Patient demographic information and colorectal cancer screening history were collected. The physician screening recommendation rate was 9.2% (n=59); 7.0% (n=45) of patients were determined to have been appropriately screened for colorectal cancer, primarily by Fecal Occult Blood Test (94.1%, n=43). Among patients who received a recommendation from their physician, 76.2% had completed a screening test. Older patients were more likely than their younger counterparts to have received a recommendation from their physician (p<.05) and to have been screened (p<.01). Organizational interventions are needed to support physicians in medically underserved areas and to promote recommended screening practices.