Primary care provider's (PCP) perceptions of colorectal cancer screening test effectiveness and their recommendations for testing intervals influence patient screening uptake. Few large studies have examined providers’ perceptions and recommendations, including their alignment with evidence suggesting comparable test effectiveness and guideline recommendations for screening frequency. Providers (n = 1,281) within four healthcare systems completed a survey in 2017–2018 regarding their perceptions of test effectiveness and recommended intervals for colonoscopy and fecal immunochemical testing (FIT) for patients ages 40–49, 50–74, and ≥75 years. For patients 50–74 (screening eligible), 82.9% of providers rated colonoscopy as very effective versus 59.6% for FIT, and 26.3% rated colonoscopy as more effective than FIT. Also, for this age group, 77.9% recommended colonoscopy every 10 years and 92.4% recommended FIT annually. For patients ages 40–49 and ≥75, more than one-third of providers believed the tests were somewhat or very effective, although >80% did not routinely recommend screening by either test for these age groups. Provider screening test interval recommendations generally aligned with colorectal cancer guidelines; however, 25% of providers believed colonoscopy was more effective than FIT for mortality reduction, which differs from some modeling studies that suggest comparable effectiveness. The latter finding may have implications for health systems where FIT is the dominant screening strategy. Only one-third of providers reported believing these screening tests were effective in younger and older patients (i.e., <50 and ≥75 years). Evidence addressing these beliefs may be relevant if cancer screening recommendations are modified to include older and/or younger patients.

中文翻译：

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初级保健提供者关于四个医疗保健系统中结肠直肠癌筛查的信念和建议。

初级保健提供者 (PCP) 对结直肠癌筛查测试有效性的看法及其对测试间隔的建议会影响患者筛查的接受度。很少有大型研究检查提供者的看法和建议，包括他们与证据的一致性，表明可比较的测试有效性和筛查频率的指南建议。四个医疗保健系统中的提供者（n = 1,281）在 2017-2018 年完成了一项调查，内容涉及他们对 40-49、50-74 和 75 岁以上患者的结肠镜检查和粪便免疫化学检测 (FIT) 的测试有效性和推荐间隔的看法. 对于 50-74 岁的患者（符合筛查条件），82.9% 的提供者认为结肠镜检查非常有效，而 FIT 为 59.6%，26.3% 认为结肠镜检查比 FIT 更有效。此外，对于这个年龄组，77。9% 建议每 10 年进行一次结肠镜检查，92.4% 建议每年进行一次 FIT。对于年龄在 40-49 岁和 75 岁以上的患者，超过三分之一的提供者认为这些测试有些或非常有效，尽管 >80% 的人不常规建议通过这两种测试对这些年龄组进行筛查。提供者筛查测试间隔建议通常与结直肠癌指南一致；然而，25% 的提供者认为结肠镜检查在降低死亡率方面比 FIT 更有效，这与一些表明有效性相当的模型研究不同。后一个发现可能对 FIT 是主要筛查策略的卫生系统产生影响。只有三分之一的提供者报告相信这些筛查测试对年轻和年长的患者（即 <50 岁和 75 岁以上）有效。