DO GASTROENTEROLOGISTS THEMSELVES FOLLOW THE AMERICAN-CANCER-SOCIETY RECOMMENDATIONS FOR COLORECTAL-CANCER SCREENING

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.