Table 1.
Association of provider characteristics and beliefs that screening tests are effective at reducing colorectal cancer mortality and recommending screening at guideline-recommended intervals
| Belief in Test Effectiveness | Recommend Guideline-Recommended Screening Intervals | |||
|---|---|---|---|---|
| Colonoscopy OR [95% CI]† | FIT OR [95% CI]† | Colonoscopy every 10 years OR [95% CI]‡ | FIT annually OR [95% CI]‡ | |
| Provider beliefs about the effectiveness of the screening test in reducing colorectal cancer mortality | ||||
| Very Effective (>50% reduction) | - | - | 1.33 [0.87–2.03] | 1.65 [0.88–3.12] |
| Somewhat or Very Effective (20–50% reduction) | - | - | 1.00 [reference] | 1.00 [reference] |
| Not Very Effective (<20% reduction) | - | - | 2.21 [0.25–19.22] | 0.50 [0.19–1.31] |
| Effectiveness Not Known | - | - | 1.40 [0.47–4.15] | 1.76 [0.36–8.71] |
| Age, years | ||||
| <40 | 0.85 [0.37–1.97] | 0.97 [0.55–1.69] | 1.21 [0.80–1.83] | 0.94 [0.43–2.03] |
| 40–49 | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
| 50–59 | 1.13 [0.46–2.81] | 1.26 [0.69–2.29] | 1.01 [0.68–1.52] | 1.10 [0.49–2.47] |
| ≥60 | 1.18 [0.41–3.36] | 1.63 [0.71–3.75] | 0.69 [0.41–1.16] | 0.70 [0.27–1.81] |
| Sex | ||||
| Male | 0.34 [0.17–0.68] | 0.72 [0.45–1.13] | 1.10 [0.79–1.54] | 1.02 [0.56–1.87] |
| Female | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
| Medical specialty/provider type | ||||
| Family Medicine Physician | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
| General Internal Medicine Physician | 0.67 [0.33–1.37] | 0.64 [0.39–1.03] | 1.53 [1.09–2.15] | 0.90 [0.49–1.64] |
| Other Primary Care Provider* | 2.79 [0.34–22.92] | 1.66 [0.45–6.10] | 0.60 [0.26–1.39] | 0.43 [0.09–1.93] |
| Average number of office visits/week | ||||
| ≤50 | 0.53 [0.20–1.36] | 1.27 [0.64–2.54] | 0.85 [0.54–1.36] | 0.46 [0.21–1.01] |
| 51–75 | 0.90 [0.34–2.38] | 1.25 [0.66–2.40] | 0.87 [0.58–1.30] | 1.15 [0.46–2.88] |
| 76–100 | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
| >101 | 0.52 [0.18–1.47] | 0.63 [0.34–1.17] | 1.08 [0.67–1.74] | 0.95 [0.38–2.39] |
| Healthcare system site | ||||
| KPNC | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
| KPSC | 1.60 [0.66–3.89] | 0.43 [0.25–0.73] | 8.20 [5.02–13.40] | 0.44 [0.21–0.92] |
| KPWA | 0.30 [0.11–0.83] | 0.29 [0.13–0.68] | 4.43 [2.43–8.06] | 3.36 [0.65–17.44] |
| Parkland-UTSW | 0.41 [0.13–1.26] | 0.17 [0.08–0.40] | 7.56 [2.85–20.03] | 0.13 [0.05–0.33] |
FIT, fecal immunochemical test; OR, odds ratio; CI, confidence interval; KPNC, Kaiser Permanente Northern California; KPSC, Kaiser Permanente Southern California; KPWA, Kaiser Permanente Washington; Parkland-UTSW, Parkland Health and Hospital System/University of Texas, Southwestern
Other primary care provider includes physician assistant (n=1), registered nurse (n=1), nurse practitioner (n=11) and other allied health professional (n=43)
Odds ratios adjusted for provider age, sex, medical specialty/provider type, average number of office visits per week, and healthcare system site.
Odds ratios adjusted for provider beliefs in effectiveness of test in reducing colorectal cancer mortality and provider age, sex, medical specialty/provider type, average number of office visits per week, and healthcare system site.