Colorectal cancer screening: practices and opinions of primary care physicians
Colorectal cancer screening: practices and opinions of primary care physicians
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DOI：
10.1016/j.ypmed.2004.03.037
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发表时间：
2004-08-01
影响因子：
5.1
通讯作者：
Bryant, HE
中科院分区：
文献类型：
--
作者：
McGregor, SE;Hilsden, RJ;Bryant, HE
背景加拿大预防性卫生保健工作组（CTFPHC），在2001年，得出结论，有很好的证据，包括每年或两年一次的粪便潜血试验（FOBT）和公平的证据，包括软乙状结肠镜定期健康检查的无症状的成年人超过50岁。邮寄调查阿尔伯塔初级保健医生，以确定目前的结直肠癌（CRC）筛查实践，熟悉新的指南，意见，和障碍，筛选平均风险的病人。有效率为58.0%（n = 965）。不到一半（41.9%）的人熟悉新的加拿大指南。大多数（74.7%）建议无症状患者接受筛查;然而，只有35.6%的人为至少75%的平均风险患者提供筛查。很少（9.4%）评价粪便潜血作为一个“优秀或非常好”的筛选试验。大多数（64.1%）医生会选择结肠镜检查，如果他们自己进行筛选。有人对成本效益、目前建议的不一致和资源提出了关切。虽然支持对平均风险患者进行结直肠癌筛查，但很少有医生建议对大多数患者进行筛查。为了更广泛地接受新的加拿大指南，需要澄清指南、资源问题和有效筛查测试的可用性之间的不一致。(C)2004年癌症预防研究所和爱思唯尔公司。All rights reserved.
Background. The Canadian Task Force on Preventive Health Care (CTFPHC), in 2001, concluded that there is good evidence to include annual or biennial fecal occult blood testing (FOBT) and fair evidence to include flexible sigmoidoscopy in the periodic health examination of asymptomatic adults more than 50 years of age.Methods. Mailed survey of Alberta primary care physicians to determine current colorectal cancer (CRC) screening practices, familiarity with the new guideline, and opinions about, and barriers to, screening average-risk patients.Results. Response rate was 58.0% (n = 965). Less than half (41.9%) were familiar with the new Canadian guideline. The majority (74.7%) recommended that asymptomatic patients undergo screening; however, only 35.6% offered screening to at least 75% of average-risk patients. Few (9.4%) rated fecal occult blood as an "excellent or very good" screening test. Most (64.1%) physicians would choose colonoscopy if they themselves were to undergo screening. Concerns were raised about cost-effectiveness, inconsistencies of current recommendations, and resources.Conclusion. Although supportive of colorectal cancer screening of average-risk patients, few physicians recommend screening for the majority of their patients. Clarification of inconsistencies between guidelines, resource issues, and the availability of efficacious screening tests is required for wider acceptance of the new Canadian guideline. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.