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Medical Care Research and Review
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Physician Recommendations for Follow-Up of Positive Fecal Occult Blood Tests

K. Robin Yabroff

National Cancer Institute

Carrie N. Klabunde

National Cancer Institute

Ron Myers

Thomas Jefferson University

Martin L. Brown

National Cancer Institute

Following a positive fecal occult blood test (FOBT), physician recommendation of complete diagnostic evaluation (CDE) is an important first step to ensure identification and treatment of preinvasive or invasive colorectal cancer. Physicians may not recommend CDE, however, potentially compromising the effectiveness of colorectal cancer screening programs and the quality of care for individual patients. The authors used a theoretical model of health behavior and two national physician samples to explore factors associated with recommendations for CDE. Overall, 63 percent of the sample of physicians providing primary care and 76 percent of the gastroenterologist and general surgeon sample reported recommending CDE. Variables representing the theoretical model constructs of physician background, experience, and practice patterns; practice environment; physician psychosocial representations; and patient characteristics were significantly associated with recommendations of CDE. Development of interventions to improve recommendations of CDE is an important area for future research.

Key Words: follow-up studies • fecal occult blood test • colorectal neoplasms • mass screening • physician’s role • physician’s practice patterns

Medical Care Research and Review, Vol. 62, No. 1, 79-110 (2005)
DOI: 10.1177/1077558704271725
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