Colorectal cancer surveillance in African-American and white patients at an urban university medical center

Abstract

Colorectal cancer causes significant morbidity and mortality in the United States. Recommendations for colorectal cancer screening have been developed. This study evaluated the colorectal cancer screening practices of African-American and white patients by internal medicine resident physicians. A retrospective chart review was conducted during 1989-1994. The performance of rectal examination, fecal occult blood testing, and flexible sigmoidoscopy among patients > 50 years was evaluated. The medical records of 200 patients (90 men and 110 women) were reviewed. Ninety-one rectal examinations, 26 fecal occult blood testing, and 30 flexible sigmoidoscopies were performed. There were 129 African-American (54 men and 75 women) and 52 white (26 men and 27 women) patients. Of the African-American patients, 57 underwent a rectal examination, 17 had fecal occult blood testing, and 26 underwent flexible sigmoidoscopy. Of the white patients, 24 had a rectal examination, 8 had fecal occult blood testing, and 12 underwent flexible sigmoidoscopy. These results demonstrate that resident physicians adhered poorly to colorectal cancer screening recommendations. There was no statistically significant difference in the screening of African-American and white patients. Increased efforts should be made to improve colorectal cancer screening practices by resident physicians.