Ganry Olivier, Boche Thomas
Service d'information médicale, épidémiologie et biostatistiques, Hôpital Nord, CHU, place Pauchet, 80054 Amiens Cedex 1.
Bull Cancer. 2004 Oct;91(10):785-91.
In France, cancers are the leading causes of death in men and in women aged to 35 to 65, and the cancer incidence in Picardy area is among the highest in France. General practitioners can play a key role in prevention and early detection of cancer. The aim of this study was to assess their current clinical practices concerning risk factors like tobacco, alcohol, diet, sun exposure and cancer screening. A questionnaire on primary prevention and cancer screening practices of general practitioners (GP) in the Picardy area was administered to 480 GP (31%). Questions concerned primary prevention (tobacco, alcohol, diet, sun exposure) and cancer screening (breast, uterine cervix, colon-rectum, prostate, other cancers). In addition, the GP were also interviewed on difficulties encountered in their practice and about their perception of the prevention actions. Smoking prevention is the best structured primary prevention action, unlike alcohol prevention and advice on diet seem to be more difficult strategies. We noted a great diversity for screening, even for cancers with a consensus, like breast, uterine cervix and colon-rectum cancers. Lot of physicians reported ordering prostatic specific antigen test (91%) but are only 5% to have fecal occult blood tests. 83% of the GP screened their patients on skin cancer at least once a year. These findings suggest that general practitioners can play a key role in prevention and early detection of cancer, but have difficulties like lack of time, lack of expertise or non compliance of their patients.
在法国,癌症是35至65岁男性和女性的主要死因,皮卡第地区的癌症发病率在法国位居前列。全科医生在癌症预防和早期检测中可发挥关键作用。本研究旨在评估他们目前在烟草、酒精、饮食、阳光照射等风险因素及癌症筛查方面的临床实践。对皮卡第地区480名全科医生(占31%)进行了关于全科医生初级预防和癌症筛查实践的问卷调查。问题涉及初级预防(烟草、酒精、饮食、阳光照射)和癌症筛查(乳腺癌、子宫颈癌、结直肠癌、前列腺癌、其他癌症)。此外,还就他们在实践中遇到的困难以及对预防措施的看法对全科医生进行了访谈。预防吸烟是结构最完善的初级预防行动,而预防饮酒和饮食建议似乎是更难实施的策略。我们注意到在筛查方面存在很大差异,即使是对于乳腺癌、子宫颈癌和结直肠癌等已达成共识的癌症也是如此。许多医生报告称会开具前列腺特异性抗原检测(91%),但只有5%的医生会进行粪便潜血检测。83%的全科医生每年至少为患者进行一次皮肤癌筛查。这些发现表明,全科医生在癌症预防和早期检测中可发挥关键作用,但存在时间不足、专业知识欠缺或患者不依从等困难。