Colorectal cancer screening practise is influenced by ethnicity of medical practitioner and patient

Jenn Hian Koo*, Matthew Yibin You, Ken Liu, Maneesha D. Athureliya, Catherine W Y Tang, Diane M. Redmond, Susan J. Connor, Rupert W L Leong

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Background and Aim: Colorectal cancer (CRC) screening improves survival and requires appropriate recommendation by general practitioners (GPs). Screening practises may be influenced by barriers related to ethnicity and training. Methods: A mail survey assessed GPs' practises and the barriers towards CRC screening. The association of screening practises and demography, including GP ethnicity, medical training and practise characteristics, were evaluated. Results: Of 212 GPs (median age 54years, 73% men, 27% Caucasian, 38% foreign graduates), 87% agreed that fecal occult blood test (FOBT) screening improved survival in the average-risk patient. Considerable variations existed in the starting age (40-49years: 31%; 50years: 65%) and frequency (1-2years: 77%; 3-5years: 22%) of screening. FOBT was used for indications other than screening: anemia (59%), altered bowel habits (54%), abdominal pain (24%), and rectal bleeding (23%), and these were significantly more frequent in Asian GPs independent of medical training. GPs were less likely to recommend screening to immigrants, and most reported that immigrants were less likely to participate. More Asian and Middle Eastern GPs reported a major barrier with FOBT inaccuracy compared with Caucasian GPs (22% vs 9%, P=0.03; and 27% vs 9%, P=0.03, respectively). Conclusions: Considerable differences existed in GPs' CRC screening practises. Indications for use of FOBT and the subsequent investigation of a positive FOBT also varied according to GPs' ethnicity, independent of medical training. Patient's ethnicity and associated language and cultural barriers may affect screening uptake, which may negatively affect the health of immigrants. Resources and culture-specific interventions are recommended to improve overall screening participation.

Original languageEnglish
Pages (from-to)390-396
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number2
Publication statusPublished - 2012
Externally publishedYes


  • Colorectal cancer
  • Ethnicity
  • General practitioner
  • Screening


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