Rural and Urban Primary Care Physicians' Colorectal Screening Performance

Research center:
Lead researcher:
Project funded:
September 2019
Project completed:
June 2023

Additional research is warranted to further understand the roles of primary care physicians in assuring that their patients receive recommended colorectal cancer screenings, especially considering that primary care physicians (particularly family physicians) are the predominant clinicians in rural America. Family physicians can provide endoscopy services themselves as opposed to referring patients to other specialists, such as gastroenterologists, but these numbers are low (<5% overall). Our prior research found that the percentage of rural family physicians doing colonoscopy (6% to 4%) and endoscopy (6% to 3%) both declined from 2014 to 2016, further threatening rural access to screening.

The objectives of this project were to profile, compare, and further understand rural versus urban differences in colorectal screening performance among primary care physicians nationally. To address these issues, we analyzed data from the American Board of Family Medicine's PRIME Registry, which captures electronic health record data from more than 2,500 clinicians in approximately 800 practices located in 47 states caring for 5.4 million patients. PRIME practices are disproportionately rural, small, and independent compared to all U.S. primary care practices.