Federici Antonio, Giorgi Rossi Paolo, Bartolozzi Francesco, Farchi Sara, Borgia Piero, Guasticchi Gabriella
Agency for Public Health, Lazio Region, via di S. Costanza 53, 00198 Rome, Italy.
Prev Med. 2005 Jul;41(1):30-5. doi: 10.1016/j.ypmed.2004.11.010. Epub 2004 Dec 30.
Several international guidelines have recommended the involvement of general practitioners (GPs) in screening programs, but current evidence suggests this is very difficult. We implemented a survey to understand the attitudes, knowledge, and practices regarding colorectal cancer screening of GPs in the Lazio region.
Survey of all GPs working in 13 of the 50 districts in Lazio using a mail-in questionnaire.
Out of 1192 GPs, 699 responded (59%). Ninety-four percent consider CRC a preventable disease. Knowledge about oncological screenings is higher in GPs using the guidelines as source of information. Twenty-five percent properly recommend the available screening tests for colorectal cancer, 22% do not recommend any, 6% under-recommend, and 47% over-recommend. Adequate knowledge of oncological screenings is positively associated with correct recommendation. Thirty-two percent of GPs recommend inappropriate follow-up tests for patients with positive fecal occult blood test.
The low response rate reveals the lack of GP's interest in screening. Knowledge about screening and use of guidelines as sources of scientific information are important factors to improve attitudes about screening, but there is a large percentage of well-informed GPs who do not recommend colorectal cancer screening at all. Currently, many GPs do not properly follow the patients up after a positive FOBT.
多项国际指南建议全科医生(GP)参与筛查项目,但目前的证据表明这非常困难。我们开展了一项调查,以了解拉齐奥地区全科医生对结直肠癌筛查的态度、知识和实践情况。
使用邮寄问卷对拉齐奥50个区中13个区的所有全科医生进行调查。
1192名全科医生中,699人回复(59%)。94%的人认为结直肠癌是可预防的疾病。将指南作为信息来源的全科医生对肿瘤筛查的知识掌握得更好。25%的人正确推荐了现有的结直肠癌筛查测试,22%的人不推荐任何筛查,6%的人推荐不足,47%的人推荐过度。对肿瘤筛查的充分了解与正确推荐呈正相关。32%的全科医生对粪便潜血试验呈阳性的患者推荐了不适当的后续检查。
低回复率表明全科医生对筛查缺乏兴趣。关于筛查的知识以及将指南作为科学信息来源的使用是改善筛查态度的重要因素,但有很大比例了解情况的全科医生根本不推荐结直肠癌筛查。目前,许多全科医生在粪便潜血试验呈阳性后没有对患者进行适当的随访。