Greisinger Anthony, Hawley Sarah T, Bettencourt Judy L, Perz Catherine A, Vernon Sally W
Kelsey Research Foundation, 5615 Kirby, Suite 660, Houston, TX 77054, USA.
Cancer Detect Prev. 2006;30(1):67-74. doi: 10.1016/j.cdp.2005.10.001. Epub 2006 Feb 2.
To determine the current level of awareness and understanding about colorectal cancer (CRC) and colorectal cancer screening (CRCS) among primary care patients in order to develop interventions to educate patients about options for CRCS, help them identify CRCS preferences and make informed choices about CRCS options.
During the spring of 2001 and 2003, two sets of focus groups with primary care patients were conducted at a large multi-specialty group practice in Houston, Texas.
Participants (n = 42) in both sets of focus groups had low knowledge about CRC and expressed fear and embarrassment about CRC and CRCS. Attitudes towards the fecal occult blood test (FOBT) were mixed, with some participants considering it difficult to finish and others preferring the privacy it afforded. Some participants initially failed to recognize the difference between sigmoidoscopy (SIG) and colonoscopy (COL), and several endoscopy-specific barriers were identified such as fear of pain, embarrassment/humiliation, and dislike or fear of test preparation. Some participants felt that endoscopy was likely to be more effective than FOBT, and others clearly preferred COL to SIG. System-specific barriers to endoscopy (e.g. difficulty scheduling appointments and insurance coverage) were also identified. We found little change in the barriers reported by primary care patients, despite a two-year difference between focus groups. Participants also provided suggestions for improving CRCS including telephone, letters and/or email reminders from the clinic, videotapes and websites.
Future interventions focused on improving informed decision-making by educating primary care patients about the risks and benefits of specific test options and about the importance of early detection of CRC could prove to be effective for increasing CRCS.
确定初级保健患者对结直肠癌（CRC）和结直肠癌筛查（CRCS）的当前认知水平，以便制定干预措施，向患者宣传CRCS的选择，帮助他们确定CRCS偏好，并就CRCS选项做出明智选择。
2001年春季和2003年，在得克萨斯州休斯顿的一家大型多专科诊所对初级保健患者进行了两组焦点小组访谈。
两组焦点小组的参与者（n = 42）对CRC的了解程度较低，对CRC和CRCS表示恐惧和尴尬。对粪便潜血试验（FOBT）的态度不一，一些参与者认为难以完成，而另一些参与者则更喜欢其提供的隐私性。一些参与者最初未能认识到乙状结肠镜检查（SIG）和结肠镜检查（COL）之间的区别，还发现了一些特定于内镜检查的障碍，如害怕疼痛、尴尬/羞辱以及不喜欢或害怕检查准备。一些参与者认为内镜检查可能比FOBT更有效，而另一些参与者则明显更喜欢COL而非SIG。还发现了内镜检查的特定系统障碍（如预约困难和保险覆盖问题）。尽管焦点小组之间相隔两年，但我们发现初级保健患者报告的障碍几乎没有变化。参与者还提出了改进CRCS的建议，包括诊所的电话、信件和/或电子邮件提醒、录像带和网站。
未来通过教育初级保健患者了解特定检查选项的风险和益处以及早期发现CRC的重要性来改善明智决策的干预措施，可能对增加CRCS有效。
