Colorectal cancer screening and surveillance practices by primary care physicians: results of a national survey
Colorectal cancer screening and surveillance practices by primary care physicians: results of a national survey
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初级保健医生的结直肠癌筛查和监测实践：全国调查结果
DOI：
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发表时间：
2000
影响因子：
9.8
通讯作者：
C. Howden
中科院分区：
文献类型：
--
作者：
V. Sharma;R. Vasudeva;C. Howden
目的：结直肠癌筛查可降低其发病率和死亡率，且具有成本效益。筛查通常是初级保健医生的责任，他们可能对其实施不确定。我们旨在评估初级保健医生关于结直肠癌筛查的知识和实践，并将他们的反应与三位国家专家的反应和已发表的指南进行比较。方法：我们向2310名初级保健医生邮寄了一份邮政问卷，内容涉及人口统计学、执业性质、筛查试验的使用以及6名可能已成为筛查或监测候选人的假设患者。我们使用公布的国家指南和三位外部专家的集体意见作为所谓的“黄金标准”。结果：在所有受访者中，85.1%的人提供结直肠癌筛查。大多数人在适当的年龄开始使用合适的测试；49.8%的医生不考虑患者的年龄继续进行筛查，43.6%的医生在没有适当饮食建议的情况下进行了粪便潜血检查。此外，应答者经常对不适当的适应症进行这种测试。只有51.8%的人会在结肠镜检查后进行粪便隐血检查。结论：初级保健医生的结直肠癌筛查实践与推荐的有很大差异。许多人对不适合进行筛查的人提供筛查，并一直持续到老年。频繁、不恰当地使用粪便隐血检查会产生许多假阳性。初级保健医生通常不适当地遵循阳性测试。需要进一步开展教育工作，以改进实践，进一步降低结直肠癌的发病率和死亡率。
OBJECTIVE:Screening for colorectal cancer reduces its morbidity and mortality and is cost-effective. Screening is usually the responsibility of primary care physicians who may be unsure about its implementation. We aimed to assess primary care physicians’ knowledge and practice regarding colorectal cancer screening, and to compare their responses with those of three national experts and with published guidelines.METHODS:We mailed a postal questionnaire to 2310 primary care physicians regarding demographics, nature of practice, use of screening tests, and six hypothetical patients who may have been candidates for screening or surveillance. We used published national guidelines and the collective opinions of the three external experts as the so-called “gold standard.”RESULTS:Of all respondents, 85.1% offered colorectal cancer screening. Most used suitable tests, starting at an appropriate age; 49.8% continued screening indefinitely irrespective of patients’ age and 43.6% performed fecal occult blood testing without appropriate dietary advice to patients. Also, respondents frequently performed this test for inappropriate indications. Only 51.8% would follow a positive fecal occult blood test with colonoscopy.CONCLUSIONS:Colorectal cancer screening practices by primary care physicians vary considerably from those recommended. Many offer screening to individuals in whom it is not appropriate, and continue it into advanced age. Frequent, inappropriate use of fecal occult blood tests will produce many false positives. Primary care physicians often do not appropriately follow a positive test. Further educational efforts are needed in an attempt to improve practice and further reduce the morbidity and mortality from colorectal cancer.
影响因子：
158.5
作者：
MANDEL, JS;BOND, JH;EDERER, F
通讯作者：
EDERER, F