Federici Antonio, Giorgi Rossi Paolo, Bartolozzi Francesco, Farchi Sara, Borgia Piero, Guastcchi Gabriella
Agency for Public Health, Lazio Region, via di S. Costanza 53, 00198, Rome, Italy.
Cancer Causes Control. 2006 Feb;17(1):45-52. doi: 10.1007/s10552-005-0380-9.
To assess the effect of the provider (GPs versus hospital) on the compliance in returning the faecal occult blood test. To analyse the characteristics of the GP associated with high compliance among his beneficiaries.
A questionnaire about screening attitudes was mailed to the 1192 GPs working in 13 districts of the Lazio region. We asked the GPs to participate in a randomised trial, we sampled 130 GPs and about 1/10 of the GPs' 50-75 year old beneficiaries (n = 3657) were invited to be screened at the GP office and 1/10 (3675) at the nearest gastroenterology centre.
58.5% of the GPs completed the questionnaire and 22.7% agreed to participate in the trial. The compliance in the GP arm was 50%, in the hospital arm 16% (RR 3.4; 95% CI: 3.13-3.70). There was a high variability in the compliance obtained by the GPs. GPs with more than 25 patients visited/day and those incorrectly recommended screening of colorectal cancer obtained a lower compliance (OR 0.74, 95% CI: 0.57-0.95 and OR 0.76, 95% CI: 0.59-0.97, respectively).
The involvement of GPs in colorectal cancer screening can be very effective to enhance the compliance, but the effectiveness is dependent on their willingness to be involved.
评估医疗服务提供者（全科医生与医院）对粪便潜血试验复查依从性的影响。分析其受益人群中依从性高的全科医生的特征。
向拉齐奥地区13个区工作的1192名全科医生邮寄了一份关于筛查态度的问卷。我们邀请全科医生参与一项随机试验，抽取了130名全科医生，约1/10的50 - 75岁受益患者（n = 3657）被邀请在全科医生诊所接受筛查，1/10（3675名）在最近的胃肠病中心接受筛查。
58.5%的全科医生完成了问卷，22.7%同意参与试验。全科医生组的依从率为50%，医院组为16%（相对危险度3.4；95%可信区间：3.13 - 3.70）。不同全科医生获得的依从率差异很大。每天看诊患者超过25人的全科医生以及错误推荐结直肠癌筛查的全科医生，其依从率较低（分别为优势比0.74，95%可信区间：0.57 - 0.95和优势比0.76，95%可信区间：0.59 - 0.97）。
全科医生参与结直肠癌筛查对提高依从性可能非常有效，但效果取决于他们参与的意愿。
