Denis Bernard, Perrin Philippe, Cailleret Anne-France, Guth Francis, Ruetsch Marcel, Strentz Patrick
Association pour le Dépistage du Cancer colorectal dans le Haut-Rhin (ADECA 68).
Gastroenterol Clin Biol. 2003 Nov;27(11):992-7.
To determine knowledge, beliefs, self-reported practices and wishes of French general practitioners regarding colorectal cancer screening before the start of an organized screening program.
A postal survey of the 600 general practitioners of the Haut-Rhin area was made in 2002.
Response rate was 62%. Eighty-five% asked routinely their patients about their family history of colorectal cancer. Colorectal cancer screening was routinely proposed by 92% of practitioners to individuals with a family history (86% with colonoscopy) and by 20% to individuals without family history (69% with faecal occult blood test). Seventy-five% did not know French consensus conference guidelines on colorectal cancer screening. Fifty-three% ordered routinely faecal occult blood testing, mostly for the screening of individuals with family history and for the evaluation of symptoms, mainly iron-deficiency anemia and weight loss. Seventy-seven% would explore with colonoscopy subjects with positive faecal occult blood test. Fifty-four% had personally undergone screening. Fifty-six% considered that mass screening could reduce a lot colorectal cancer mortality and most of them agreed with the forthcoming organized colorectal cancer mass screening program.
Screening for colorectal cancer is ordered less often than screening for female cancers. General practitioners are unaware of current guidelines. Beliefs and practices vary considerably and faecal occult blood testing is often inappropriately prescribed. Medical education concerning screening is needed. Colorectal cancer screening guidelines and policy should be clarified in France.
在一项有组织的筛查项目启动之前，确定法国全科医生关于结直肠癌筛查的知识、信念、自我报告的做法及意愿。
2002年对上莱茵地区的600名全科医生进行了邮寄调查。
回复率为62%。85%的医生会定期询问患者的结直肠癌家族史。92%的医生会定期向有家族史的个体提议进行结直肠癌筛查（86%采用结肠镜检查），20%的医生会向无家族史的个体提议进行筛查（69%采用粪便潜血试验）。75%的医生不了解法国关于结直肠癌筛查的共识会议指南。53%的医生会定期进行粪便潜血检测，主要用于筛查有家族史的个体以及评估症状，主要是缺铁性贫血和体重减轻。77%的医生会对粪便潜血试验呈阳性的受试者进行结肠镜检查。54%的医生个人接受过筛查。56%的医生认为大规模筛查可大幅降低结直肠癌死亡率，且他们中的大多数人赞同即将开展的有组织的结直肠癌大规模筛查项目。
结直肠癌筛查的开展频率低于女性癌症筛查。全科医生不了解现行指南。信念和做法差异很大，粪便潜血检测的处方往往不恰当。需要开展关于筛查的医学教育。法国应明确结直肠癌筛查指南和政策。
