Tucunduva Luciana Tomanik Cardozo de Mello, Sá Victor Hugo Lara Cardoso de, Koshimura Erika Tae, Prudente Fernanda Vilas Boas, Santos Andréa Felice dos, Samano Eliana Sueco Tibana, Costa Luciano José Megale, Del Giglio Auro
Faculdade de Medicina do ABC, Santo André, SP.
Rev Assoc Med Bras (1992). 2004 Jul-Sep;50(3):257-62. doi: 10.1590/s0104-42302004000300030. Epub 2004 Oct 21.
New cancer cases are most often diagnosed by non-oncologist physicians. It is therefore essential for all physicians to be aware of cancer preventive practices and use them appropriately with their patients.
Questionnaires were administered to 120 non-oncologist physicians of various specialties attending the "Faculdade de Medicina do ABC" who deal directly with adult patients. Replies were collected and classified as appropriate or not according to one of these three cancer prevention guidelines: INCA, American Cancer Society and Canadian Task Force.
The percentage of replied questionnaires was 58.3% (70 questionnaires). Mean age of physicians was 33.9 years; 57.1% were women and 10% smokers. Most of the current preventive practices adopted by the participating physicians (45.72% to 100%) regarding the most common and preventable tumors (breast, cervix, prostate, colon and rectum and non-melanoma skin cancer) did not agree with any of the guidelines mentioned above. When questioned about possible impediments for the appropriate practice of cancer prevention, 82.86% reported absence of health education agents working with the population, 77.14% scarceness of knowledge or training concerning prevention, and 70.15% lack of financial support for ordering tests. Frequently, whenever there was disagreement between the guidelines and the physician's current practices, preventive tests were ordered in excess of those recommended by the guidelines.
Physicians had a tendency to order excessive laboratory tests, an action which can be related to lack of knowledge and to divergence among guidelines. A more intensive educational effort regarding cancer prevention, directed towards teaching physicians in training, seems to be warranted.
大多数癌症新病例是由非肿瘤专科医生诊断出来的。因此，所有医生都必须了解癌症预防措施，并在患者中适当地运用这些措施。
对参加“ABC医学院”的120名直接诊治成年患者的各专科非肿瘤专科医生进行问卷调查。根据以下三项癌症预防指南之一：巴西癌症研究所（INCA）、美国癌症协会和加拿大预防保健工作组，收集回复并将其分类为适当或不适当。
问卷回复率为58.3%（70份问卷）。医生的平均年龄为33.9岁；57.1%为女性，10%为吸烟者。参与调查的医生针对最常见且可预防的肿瘤（乳腺癌、宫颈癌、前列腺癌、结肠癌和直肠癌以及非黑色素瘤皮肤癌）所采取的当前预防措施中，大部分（45.72%至100%）与上述任何一项指南均不一致。当被问及癌症预防适当措施的可能障碍时，82.86%的人报告称缺乏针对人群开展工作的健康教育人员，77.14%的人表示缺乏预防方面的知识或培训，70.15%的人提到缺乏订购检测的资金支持。通常，每当指南与医生当前的做法存在分歧时，所订购的预防性检测就会超过指南推荐的数量。
医生有过度订购实验室检测的倾向，这种行为可能与知识缺乏以及指南之间的差异有关。似乎有必要针对预防癌症开展更深入的教育工作，目标是培训中的医生。
