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Updated: Jun 20, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Use of colon cancer testing in rural Colorado primary care practices
Linda Overholser1, Linda Zittleman, Allison Kempe
1Department of Internal Medicine, Division of General Internal Medicine, University of Colorado-Denver, 360 S. Garfield Street, Denver, CO 80209, USA. Linda.Overholser@ucdenver.edu
Background:
People living in rural areas may be less likely to be up to date (UTD) with screening guidelines for colorectal cancer (CRC).
Objectives:
To determine (1) rates of being UTD with screening or ever having had a test for CRC and (2) correlates for testing among patients living in a rural area who visit a provider.
Design:
Cross-sectional survey.
Participants:
Five hundred seventy patients aged 50 years and older who visited their health-care provider in High Plains Research Network (HPRN) practices.
Measurements:
(1) Ever having had a CRC screening test, (2) being UTD with CRC screening, and (3) intention to get tested.
Results:
The survey completion rate was 65%; 71% of patients had ever had any CRC screening test, while 52% of patients were UTD. Correlates of intending to get tested included having a family history of CRC, having a doctor recommend a test, knowing somebody who got tested, and believing that testing for CRC gives one a feeling of being in control of their health. Of those who had never had a CRC screening test, 12% planned on getting tested in the future, while 55% of those who were already up to date intended to be tested again (p < 0.001).
Conclusions:
Prevalence of being UTD with CRC testing in the HPRN was on par with statewide CRC testing rates, but over three quarters of patients who had not yet been screened had no intention of getting tested for CRC, despite having a medical home.
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