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UW Health SMPH
American Family Children's Hospital

Research Pilot: Primary Care Provider Barriers to Colon Cancer Screening

By: Dr. Jennifer Weiss,UW Hospital, Medicine and Clinical Oncology


  • Patrick Pfau, Gastroenterology/Hepatology, UW School of Medicine and Public Health
  • Sally Kraft, Medicine, UW School of Medicine and Public Health
  • Maureen Smith, Population Health, UW School of Medicine and Public Health
  • Perry Pickhardt, Radiology, UW School of Medicine and Public Health
  • Michael Lucey, Gastroenterology/Hepatology, UW School of Medicine and Public Health

Colorectal cancer (CRC) is the third-leading cause of cancer death in the U.S. for both men and women. CRC is preventable through the use of many screening tests to detect and remove polyps that can progress to cancer. Currently available techniques have the capability to decrease mortality from this disease by up to 75-90 percent. Yet, despite this knowledge they continue to be underutilized.


CRC screening rates are astoundingly low (40-45 percent) on a national level. In Madison, Wisconsin the rates are better (60 percent), but still far from ideal. Many barriers to CRC screening have been identified on a national level with respect to patients, providers and the health system. Regional variations in these barriers do exist such as access to providers who conduct CRC screening exams and insurance coverage.


Madison is a unique environment where all major third party payers cover virtual colonoscopy performed by radiologists as a CRC screening modality. Yet 40 percent of these patients are still not getting screened and we continue to see variability in screening rates both between and within clinics.


In order to develop targeted interventions in the UW Health system to improve our CRC screening rates, it is imperative that we assess barriers unique to our community. This research pilot will survey primary care providers to better understand attitudes toward CRC screening, CRC screening beliefs and practices, and system-related issues within UW Health.


The information gathered from this study will be immediately translated into large-scale interventions to improve care in UW Health clinics thereby increasing CRC screening rates locally and potentially at a statewide level. The survey will be administered through the UW Survey Center and is anticipated to reach primary care providers late summer/early fall 2009.