The practices and attitudes of primary care nurse practitioners and physician assistants with respect to colorectal cancer screening

OBJECTIVES: Although nurse practitioners and physician assistants form a la rge and growing portion of the primary care workforce, little is known abou t their colorectal cancer screening practices. The aim of this study was to assess the colorectal cancer screening practices, training, and attitudes of nurse practitioners and physician assistants practicing primary care med icine. METHODS: All nurse practitioners (827) and physician assistants (1178) lice nsed by the Medical Board of the State of North Carolina were surveyed by m ail. Both groups were further divided into primary care versus non-primary care by self-described roles. Self-reported practices, training, and attitu des with respect to colorectal cancer screening were elicited. RESULTS: Response rates were 71.4% and 61.2%, for nurse practitioners and p hysician assistants respectively. A total of 51.3% of nurse practitioners a nd 50.3% of physician assistants described themselves as adult primary care providers. No primary care nurse practitioners and only 3.8% of primary ca re physician assistants performed screening flexible sigmoidoscopy. However , 76% of primary care physician assistants and 69% of primary care nurse pr actitioners reported recommending screening flexible sigmoidoscopy. A total of 95% primary care physician assistants and 92% of primary care nurse pra ctitioners reported performing fecal occult blood testing. Only 9.4% of phy sician assistants and 2.8% of nurse practitioners received any formal instr uction in flexible sigmoidoscopy while in their training. Additionally, 41. 4% of primary care physician assistants and 27.7% of primary care nurse pra ctitioners reported that they would be interested in obtaining formal train ing in flexible sigmoidoscopy. CONCLUSIONS: Physician assistants and nurse practitioners are motivated, wi lling and underutilized groups with respect to CRC screening. Efforts to in crease education and training of these professionals may improve the availa bility of CRC screening modalities. (C) 2000 by Am. Cell. of Gastroenterolo gy.