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Knowledge, Symptom Awareness, and Referral Practices of Primary Care Providers in Early-Onset Colorectal Cancer

Year: 2026

Type: article

Abstract: Colorectal cancer (CRC) incidence and death rates are increasing among people under age 50 in the United States. In addition to promoting on-time screening for average-risk adults starting at age 45, CRC signs and symptoms may need timely assessment by a health care provider to rule out other conditions and identify a diagnosis. The objective of this study was to examine primary care providers' (PCPs') awareness of CRC-related symptoms and their diagnostic approaches for patients under age 50 using the 2023 DocStyles panel survey. This survey included 1490 PCPs practicing in the United States. A descriptive analysis was conducted to examine symptom awareness and referral practices. Log binomial regression was used to examine predictors of greater symptom awareness. Symptom awareness of early-onset CRC was highest for changes in bowel habits (79%) and lowest for abdominal pain (43%). Fewer obstetricians/gynecologists and physician assistants were aware of CRC signs and symptoms. Most PCPs would complete a workup and assess patients for family history of cancer for patients presenting with rectal bleeding/bloody stools, iron deficiency anemia, or changes in bowel habits. Around 45% of PCPs would refer patients with rectal bleeding/bloody stools to diagnostic colonoscopy or offer a stool-based screening test. Some PCPs may benefit from additional training on signs and symptoms of early-onset CRC and evidence-based guidelines for symptom assessment. These findings indicate that many PCPs prefer to complete a medical workup and assess for family history of cancer as first steps, and most would not immediately refer patients to diagnostic colonoscopy.

Source: Population Health Management

DOI: 10.1177/19427891251411924

Authors: Julie S. Townsend, Mary C. Puckett, Sallyann M. Coleman King, Djenaba A. Joseph

Institution: Centers for Disease Control and Prevention

Language: English

Topic: Colorectal Cancer Screening and Detection

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention