Oxentenko Amy S, Vierkant Robert A, Pardi Darrell S, Farley David R, Dozois Eric J, Hartman Thomas E, Hough David M, Petersen Wesley O, Klabunde Carrie N, Sharpe Katherine, Bond John H, Smith Robert A, Levin Bernard, Pope John B, Schroy Paul C, Limburg Paul J
Mayo Clinic College of Medicine, Rochester, MN, USA.
J Cancer Educ. 2007 Winter;22(4):219-26. doi: 10.1007/BF03174120.
Colorectal cancer (CRC) screening in the United States is suboptimal. We conducted a national survey to learn about CRC screening perceptions and practices among trainees who perform CRC screening tests including those enrolled in Gastroenterology and Hepatology (GIH), General and Colorectal Surgery, and Diagnostic and Abdominal Radiology training programs.
Program directors/administrators (PDs/PAs) from 642 programs were contacted by e-mail with an invitation to forward our survey to trainees in their programs. Participating trainees then completed an anonymous, Web-based questionnaire.
A total of 130/642 (20%) PDs/PAs forwarded our survey to their trainees, with responses received from 476 trainees (80 GIH, 261 surgery, 135 radiology). Colonoscopy was felt to be the best CRC screening test at reducing CRC mortality, with patient-related factors perceived as greater barriers than system-related factors. No single guideline was deemed very influential on CRC screening practices by most trainees. A total of 2 of 5 above-average risk patient profiles were not recognized by most trainees. Colonoscopy was selected as the preferred follow-up test for a positive CRC screening test by most trainees. However, 34% of respondents chose an option other than colonoscopy alone for follow-up of a positive fecal occult blood test.
Based on data from this national survey of gastroenterology, surgery, and radiology trainees, opportunities exist for curricular changes that may help enhance current perceptions and practices of trainees who perform CRC screening tests.
美国的结直肠癌（CRC）筛查情况并不理想。我们开展了一项全国性调查，以了解进行CRC筛查测试的学员（包括参加胃肠病学和肝病学（GIH）、普通外科和结直肠外科以及诊断性和腹部放射学培训项目的学员）对CRC筛查的看法和实践情况。
通过电子邮件联系了来自642个项目的项目主任/管理人员（PDs/PAs），邀请他们将我们的调查问卷转发给所在项目的学员。参与调查的学员随后完成了一份基于网络的匿名问卷。
共有130/642（20%）的PDs/PAs将我们的调查问卷转发给了他们的学员，共收到476名学员的回复（80名GIH学员、261名外科医生学员、135名放射科医生学员）。结肠镜检查被认为是降低CRC死亡率的最佳筛查测试，与患者相关的因素被视为比与系统相关的因素更大的障碍。大多数学员认为没有单一的指南对CRC筛查实践有很大影响。大多数学员未识别出5种高于平均风险患者特征中的2种。大多数学员选择结肠镜检查作为CRC筛查呈阳性后的首选后续测试。然而，34%的受访者在粪便潜血试验呈阳性的后续检查中选择了结肠镜检查以外的其他选项。
根据这项针对胃肠病学、外科和放射学学员的全国性调查数据，存在课程改革的机会，这可能有助于提升进行CRC筛查测试的学员目前的认知和实践水平。
