Sa. Afridi et al., DO GASTROENTEROLOGISTS THEMSELVES FOLLOW THE AMERICAN-CANCER-SOCIETY RECOMMENDATIONS FOR COLORECTAL-CANCER SCREENING, The American journal of gastroenterology, 89(12), 1994, pp. 2184-2187
Objective: Colorectal cancer is a leading cause of mortality from canc
er in the United States. Unfortunately, many patients already have adv
anced disease by the time symptoms occur. Screening of asymptomatic pe
rsons offers the potential of detecting the disease at its early and c
urable stages. The American Cancer Society (ACS) screening recommendat
ions are the most widely employed in this country. We sought to determ
ine whether gastroenterologists themselves follow the ACS recommendati
ons, and if not, to determine their reasons for not doing so. We also
looked at gastroenterologists' use of diets and supplements that might
reduce the likelihood of colorectal cancer. Method: A questionnaire w
as mailed out to all gastroenterologists with U.S. addresses listed in
the American College of Gastroenterology membership directory. Result
s: Of 1466 respondents, 330 were excluded because they were at high ri
sk for colorectal cancer or were not gastroenterologists. This left 87
5 gastroenterologists age 40 years and over and 261 gastroenterologist
s under age 40 for analysis. Overall, 68% of respondents felt the ACS
recommendations were adequate; 32% did not. Of those who disagreed wit
h the ACS recommendations, 58% preferred screening colonoscopy, and 22
% preferred flexible sigmoidoscopy without annual fecal occult blood t
esting. Of gastroenterologists age 40 and over, 38% strictly followed
the ACS recommendations themselves, 39% partially, and 23% did not fol
low them. Fifty percent of those who did not strictly follow the recom
mendations believed they were adequate but procrastinated or ''did not
have the time'' to follow them. Overall, 82% of gastroenterologists s
aid they used a high fiber diet, 68% used a diet low in fat, 18% used
a calcium supplement, and 25% used aspirin regularly. Conclusions: Alt
hough two-thirds of gastroenterologists agreed with the ACS recommenda
tions, only 38% themselves followed them strictly. Of the approximatel
y one-third of gastroenterologists who considered them inadequate, a m
ajority preferred screening colonoscopy. Gastroenterologists were more
aggressive in following dietary practices that might help prevent col
orectal cancer development than they were in undergoing screening.