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Shortage of Female Endoscopists a Barrier to Colon Cancer Screening: Presented at DDW

By Charlene Laino

NEW ORLEANS, LA -- May 19, 2004 -- American researchers report they have uncovered a previously overlooked barrier to colon cancer screening: a shortage of female endoscopists.

Stacy Menees, MD, a fellow in gastroenterology at the University of Michigan Health System, Ann Arbor, Michigan, presented the findings here on May 18^th at Digestive Disease Week.

Other studies have shown that, in general, up to 60% of women prefer a female physician, she said. However, no researchers have previously examined whether women undergoing colonoscopy for colorectal cancer screening prefer a female endoscopist.

"Screening is suboptimal. Only 50% of people who should be undergoing colonoscopy are actually getting the procedure," she said. "We need to find out why."

For the study, Dr. Menees and colleagues asked female patients awaiting primary care appointments at four offices to fill out a questionnaire based on theoretical constructs from validated surveys and their previous work. A total of 202 women, with an average age of 53 years, completed the questionnaire.

Responses to the survey show that 43% of the women preferred a female endoscopist, Dr. Menees reported. More importantly, she said, 5% of the women said they would absolutely not undergo a colonoscopy unless guaranteed a female endoscopist.

Of those who preferred a female endoscopist, 87% were willing to wait more than 30 days for a woman and 14% were willing to pay more, the survey showed. The most common reason for wanting a female endoscopist, cited by three-fourths of respondents, was embarrassment, she said.

Multivariate analysis showed that women whose primary care physicians were women were 3.4 times more likely to want a female endoscopist than those who had a male physician (95% CI =1.59, 5.63), Dr. Menees said.

Also, women who were employed were 2.5 times more likely to prefer a female endoscopist than those who did not work (95% CI =1.21, 4.51), Dr. Menees said.

The sole independent factor associated with adherence to screening was a recommendation from their primary care physicians. Women were nearly three times more likely to undergo a colonoscopy if their physician recommended the test (95% CI=1.63-5.39). One in two women said their physicians told them to have a colonoscopy, Dr. Menees said.

Primary care physicians must be more proactive in recommending colonoscopy to their patients, she said. Also, if a patient prefers a female endoscopist and none is available, "It's up to clinicians to talk to their patients and address any feelings of embarrassment," she added.


[Presentation title: "Women's preference for women physicians is a barrier to colorectal cancer screening."]

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