Colorectal cancer screening and familial risk: A survey of internal medicine residents' knowledge and practice patterns
Colorectal cancer screening and familial risk: A survey of internal medicine residents' knowledge and practice patterns
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DOI：
10.1016/s0002-9270(03)00256-9
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发表时间：
2003-06-01
影响因子：
9.8
通讯作者：
Schroy, PC
中科院分区：
文献类型：
--
作者：
Barrison, AF;Smith, C;Schroy, PC
目的：风险分层对于正确使用结直肠癌筛查建议至关重要。本研究的主要目的是评估内科 (IM) 住院医师关于家族性结直肠癌的知识和筛查行为。 方法：我们对两个大学项目的内科住院医师 (n = 127) 研究生培训第二年和第三年进行了调查。该调查工具评估了医生对有结直肠癌、腺瘤性息肉、家族性腺瘤性息肉病和遗传性非息肉性结直肠癌家族史的个体的筛查建议和当前实践的了解。该工具还得出有关家庭风险评估、记录和高危家庭成员通知的数据。结果：81 名符合 IM 资格的居民 (81%) 完成了调查。大多数受访者认为结直肠癌家族史是评估结直肠癌风险的重要因素，并适当实施了相关筛查建议。然而，对于 60 岁之前诊断出的有腺瘤息肉家族史的患者来说，对 40 岁时筛查建议的了解和遵守情况相对较差。更重要的是，对于家族性腺瘤性息肉病和遗传性非息肉性结直肠癌患者，受访者缺乏必要的风险评估技能和知识来正确实施当前的建议。根据项目地点或研究生年份状况进行分层时，知识或筛查行为没有一致的差异。结论：许多 IM 住院医师缺乏对有家族性结直肠癌风险的患者的知识、风险评估技能和筛查实践。需要有效的教育策略来提高对家庭风险、风险评估技能和适当使用相关筛查指南的认识。 （Am J Gastroenterol 2003；98：1410-1416。(C) 2003，Am. Coll. of Gastroenterology）。
OBJECTIVE: Risk stratification is essential to the appropriate use of colorectal cancer screening recommendations. The principal objective of this study was to assess the knowledge and screening behavior of internal medicine (IM) residents regarding familial colorectal cancer.METHODS: We conducted a survey of IM residents in their second and third year of postgraduate training from two university-based programs (n = 127). The survey instrument assessed physician knowledge of screening recommendations and current practices for individuals with a family history of colorectal cancer, adenomatous polyps, familial adenomatous polyposis, and hereditary nonpolyposis colorectal cancer. The instrument also elicited data regarding familial risk assessment, documentation, and notification of at-risk family members.RESULTS: Eighty-one IM eligible residents (81%) completed the survey. Most respondents identified a family history of colorectal cancer as an important factor in assessing colorectal cancer risk and appropriately implemented relevant screening recommendations. However, for patients with a family history of adenomatous polyps diagnosed before age 60 yr, knowledge and adherence to recommendations advocating screening at age 40 was relatively poor. More importantly, for patients with familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, respondents lacked the necessary risk assessment skills and knowledge to appropriately implement current recommendations. There were no consistent differences in knowledge or screening behavior when stratified on the basis of program site or postgraduate year status.CONCLUSION: Many IM residents are deficient in their knowledge, risk assessment skills, and screening practices for patients at familial risk of colorectal cancer. Effective educational strategies that promote awareness regarding familial risk, risk assessment skills, and appropriate use of relevant screening guidelines are needed. (Am J Gastroenterol 2003;98:1410-1416. (C) 2003 by Am. Coll. of Gastroenterology).