Screening for colorectal cancer on the front line.
Screening for colorectal cancer on the front line.
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在第一线筛查结直肠癌。
DOI：
10.1111/j.1572-0241.2003.07360.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Luckmann,Roger
中科院分区：
文献类型：
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作者：
Lemon,StephenieC;Zapka,JaneG;Estabrook,Barbara;Erban,Stephen;Luckmann,Roger
目的：本研究的目的是评估初级保健临床医生关于结直肠癌筛查的知识、信念和实践。方法：我们调查了马萨诸塞州中部6家诊所的77名初级保健提供者，以评估与结直肠癌筛查相关的几个因素。结果：大多数人同意粪便隐血检查（97%）和乙状结肠镜检查（87%）的指南，这是通常的做法。虽然大多数（86%）推荐结肠镜检查作为结直肠癌筛查试验，但作为常规做法很少报道。此外，36%的人认为钡灌肠是结直肠癌筛查的一种选择，很少有报道将其作为常规做法。尽管缺乏证据支持有效性，直肠指检和办公室粪便隐血检查通常被报道为常规做法。然而，这些通常是与指南认可的测试选项结合报道的。虽然只有10%的人报告粪便潜血检查/家庭经常被拒绝，但60%的人报告乙状结肠镜检查被拒绝。患者不愿接受乙状结肠镜检查的常见障碍包括害怕手术会带来伤害，以及患者认为一旦出现问题就会出现症状。对乙状结肠镜检查的卫生系统障碍的认识不那么强烈。结论：大多数医生推荐指南认可的结直肠癌筛查。然而，患者拒绝乙状结肠镜检查是常见的。结果表明，多层次的干预，包括患者和提供者教育和系统策略，可能有助于提高患病率。
OBJECTIVE:The aim of this study was to assess knowledge, beliefs, and practices of primary care clinicians regarding colorectal cancer screening.METHODS:We surveyed 77 primary care providers in six clinics in central Massachusetts to evaluate several factors related to colorectal cancer screening.RESULTS:Most agreed with guidelines for fecal occult blood test (97%) and sigmoidoscopy (87%), which were reported commonly as usual practice. Although the majority (86%) recommended colonoscopy as a colorectal cancer screening test, it was infrequently reported as usual practice. Also, 36% considered barium enema a colorectal cancer screening option, and it was rarely reported as usual practice. Despite lack of evidence supporting effectiveness, digital rectal examinations and in-office fecal occult blood test were commonly reported as usual practice. However, these were usually reported in combination with a guideline-endorsed testing option. Although only 10% reported that fecal occult blood test/home was frequently refused, 60% reported sigmoidoscopy was. Frequently cited patient barriers to sigmoidoscopy compliance included fear the procedure would hurt and that patients assume symptoms occur if there is a problem. Perceptions of health systems barriers to sigmoidoscopy were less strong.CONCLUSIONS:Most providers recommended guideline-endorsed colorectal cancer screening. However, patient refusal for sigmoidoscopy was common. Results indicate that multiple levels of intervention, including patient and provider education and systems strategies, may help increase prevalence.