Colorectal Cancer Screening: Physicians’ Knowledge of Risk Assessment and Guidelines, Practice, and Description of Barriers and FacilitatorsReport as inadecuate




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Canadian Journal of Gastroenterology - Volume 20 2006, Issue 11, Pages 713-718

Original Article

Department of Medicine, McGill University, Montreal, Quebec, Canada

Department of Gastroenterology, University Health Centre Hotel-Dieu, Angers, France

Department of Family Medicine, McGill University, Montreal, Quebec, Canada

Division of General Internal Medicine and Centre for Medical Education, McGill University, Montreal, Quebec, Canada

Divisions of General Internal Medicine and Critical Care, McGill University, Montreal, Quebec, Canada

Received 16 September 2005; Accepted 2 March 2006

Copyright © 2006 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC http:-creativecommons.org-licenses-by-nc-4.0-, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.

Abstract

BACKGROUND: Physician nonadherence to colorectal cancer CRC screening recommendations contributes to underuse of screening.

OBJECTIVE: To assess physicians’ knowledge of CRC screening guidelines for average-risk individuals, perceived barriers to screening and practice behaviours.

METHODS: Between October 2004 and March 2005, staff physicians working in three university-affiliated hospitals in Montreal, Quebec, were surveyed. Self-administered questionnaires assessed knowledge of risk classification and current guidelines for average-risk individuals, as well as perceptions of barriers to screening and practice behaviours.

RESULTS: All 65 invited physicians participated in the survey, including 46 70.8% family medicine physicians and 19 29.2% general internists. Most physicians knew that screening should begin at 50 years of age, all knew to screen men and women and 92% said they screened average-risk patients. Fifty-seven 87.7% physicians correctly identified three common characteristics associated with high risk for developing CRC. Physicians who screened average-risk patients preferred fecal occult blood testing 88.3% and colonoscopy 88.3% to flexible sigmoidoscopy 10.0% and double-contrast barium enema 30.0%. Most physicians knew the correct screening periodicity for fecal occult blood testing 87.6%, but only 40% or fewer could identify correct screening periodicities for the other modalities. Barriers and facilitators focused on health care delivery system improvements, better evidence on which to base recommendations and development of practical screening modalities.

CONCLUSIONS: Physicians lacked knowledge of the recommended screening modalities and periodicities to appropriately screen average-risk individuals. Because CRC screening can reduce mortality, efforts to improve physician delivery should focus on physician knowledge and changes to the health care delivery system.





Author: Maida J Sewitch, Pascal Burtin, Martin Dawes, Mark Yaffe, Linda Snell, Mark Roper, Patrizia Zanelli, and Alan Pavilanis

Source: https://www.hindawi.com/



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