The purpose of this study is to learn more about doctor-patient communication about colon cancer screening. This study will also look to see if there are differences in those who get colon cancer screening based on the discussion the doctor had with the patient.

Inclusion Criteria:

Physicians

• Attending physicians or third year residents specializing in internal medicine or family medicine, as per the medical director from the clinic.
• Clinic is based at a NYC RING-affiliated practice.
• English speaking; Due to limited resources, we cannot have each audio recorded consultation translated therefore, the consultation needs to be in English.

Patients

• Ages 50-75 years old, per the United States Preventive Services Task Force recommendations for screening. This will be determined by a pre-screening of medical records by the RSA.
• Due for colorectal cancer screening at the time of the visit, ascertained through patient self-report (e.g., no colonoscopy within the past 10 years, no flexible sigmoidoscopy or barium enema within the past five years, and no FOBT within the past year).
• Coming for either an annual physical exam or chronic care follow up visit, per patient self-report.
• Planning to consult with the physician in English, per patient self-report. Due to limited resources, we cannot have each audio recorded consultation translated therefore, the consultation needs to be in English.

Exclusion Criteria:

• History of colorectal cancer, per patient self-report or per EMR..
• History of polyps being removed, per patient self-report.
• Colonoscopy scheduled in EMR at time of screening.

Five health centers of the NYC RING will participate in this project. All are located in underserved urban communities within the Bronx.