Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2015; 7(11): 356-360
Published online Nov 15, 2015. doi: 10.4251/wjgo.v7.i11.356
Colorectal cancer screening in an academic center compared to the national average
Manuel O Gonzalez, Lilly M Sadri, Alfred B Leong, Smruti R Mohanty, Parag Mehta
Manuel O Gonzalez, Smruti R Mohanty, Department of Gastroenterology, New York Methodist Hospital, New York, NY 11215, United States
Lilly M Sadri, Department of Medicine, Stony Brook University Hospital, New York, NY 11215, United States
Alfred B Leong, Parag Mehta, Department of Medicine, New York Methodist Hospital, New York, NY 11215, United States
Author contributions: Gonzalez MO analyzed data, wrote the paper, performed research; Sadri LM analyzed data, wrote the paper; Leong AB designed research, performed research; Mehta P analyzed data, performed research; Mohanty SR analyzed data and made critical revisions.
Institutional review board statement: This study received approval by New York Methodist Hospital Institutional Review Board Committee (IRB reference No. 518027).
Informed consent statement: Waiver of informed consent was approved by the New York Methodist Hospital Institutional Review Board Committee as the study was an observational study and demonstrated minimal risk.
Conflict-of-interest statement: There are no conflicts of interests to be disclosed by any of the authors.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at New York Methodist Hospital, who will provide a permanent, citable and open-access home for the dataset.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Manuel O Gonzalez, MD, Department of Gastroenterology, New York Methodist Hospital, 506 Sixth Street, Brooklyn, New York, NY 11215, United States. drmgonzalez@aol.com
Telephone: +1-305-5622807
Received: April 14, 2015
Peer-review started: April 16, 2015
First decision: June 2, 2015
Revised: June 22, 2015
Accepted: September 2, 2015
Article in press: September 7, 2015
Published online: November 15, 2015

AIM: To investigate if the increased emphases on training and education on current colorectal cancer (CRC) screening guidelines has resulted in improved national CRC screening rates in an internal medicine training program, and to determine if the doctor’s post graduate year (PGY) level of training affected CRC screening rates.

METHODS: We conducted a cross sectional study of every patient who presented to the outpatient clinic of New York Methodist Hospital, Brooklyn, NY, over the span of six continuous weeks in 2011. A questionnaire was integrated into every patient’s medical interview that helped determine that patient’s current CRC screening status, screening mammography status if applicable, Papanicolaou smear status if applicable, and current pneumococcal vaccination status. At the same time, patient demographics were also obtained. All of the questionnaire data was collected at the end of each medical visit and was compiled by a designated researcher. After all the data points were collected, it was ensured that the patient has been seen by his or her continuity care resident at least twice in the past. Data was then compiled into a secure, encrypted database to then be analyzed by our statistician.

RESULTS: Data from 547 consecutive clinic visits were obtained. Of these, we reviewed 483 charts that met all of the inclusion criteria and did not meet the exclusion criteria. The data was then analyzed for differences between PGY levels, patient’s sex, race, and educational level. The study population consisted of 138 men and 345 women. 35 patients were white (7.40%), 174 were black (39.79%) and 264 were Hispanic (55.81%). Our CRC screening rates were: 66% for PGY-1’s, 72% for PGY-2’s and 77% for PGY-3’s. There was no statistical difference noted between the three groups (P≤ 0.05) or was there any difference sex, insurance status or educational level. Overall CRC screening rate was 72% which was not different from the New York State average (P < 0.05). There was a statistically significant higher rate of CRC screening amongst Hispanics 76% (P = 0.034) and in people within the ages of 70-79, 82% (P = 0.015).

CONCLUSION: Patients that are followed by internal medicine residents at our urban outpatient teaching clinic did not receive higher rates of CRC screening nor did rates of screening vary with their PGY level.

Keywords: Screening, Colorectal cancer, Post graduate year, Colorectal cancer, Residency, Urban

Core tip: It is assumed that greater seniority and experience amongst medical residents can equal improved colorectal cancer screening percentage in an outpatient academic center. We not only compare screening rates between different post graduate years but also compare the medical resident’s screening rates to the national average.