Most adults overdue for colorectal cancer screening report not receiving a clinician recommendation

Most adults overdue for colorectal cancer (CRC) screening report that they did not receive a screening recommendation from their clinician during a wellness visit in the past year, especially among historically marginalized populations.

Even if some adults underreported receiving a recommendation due to low recall (e.g., not remembering or understanding what was discussed with their clinician during a past appointment), the findings highlight a major communication gap about CRC prevention in the clinical setting. The findings are published in Annals of Internal Medicine.

More than 1 in 3 U.S. adults is overdue for CRC screening. Receiving a clinician recommendation is the strongest and most consistent determinant of CRC screening participation. Lack of clinician recommendation may contribute to low uptake of CRC screening, but the magnitude of this problem is unknown.

Researchers from the American Cancer Society, Surveillance and Health Equity Science pooled nationally representative data from the 2019 and 2021 National Health Interview Survey to estimate, the prevalence of receiving a clinician recommendation for CRC screening among underscreened U.S. adults, overall and by demographic, socioeconomic, and health care access characteristics.

The analysis included 5,022 adults who were eligible and overdue for CRC screening and had a wellness visit in the past year. Overall, only about a quarter of respondents reported receiving a clinician recommendation for CRC screening and the rate of recommendation was lowest among marginalized racial/ethnic and socioeconomic groups. The authors suggest that interventions are needed to remove barriers that prevent effective counseling on CRC prevention.