Lachter Jesse, Leska-Aharoni Tal, Warum Daniel, Eliakim Rami
Department of Gastroenterology, Rambam Medical Center and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Isr Med Assoc J. 2008 Aug-Sep;10(8-9):621-6.
The frequency of colorectal cancer screening tests in Israel is poor, and is much lower than in the United States. This low rate has been attributed to health system failures as well as to barriers on the part of both physicians and patients.
To further identify particular health system failures, physician and patient-based barriers, and the effectiveness of public lectures in improving the frequency of performance of CRC screening tests.
Public lectures on colorectal cancer prevention were held. A gastroenterologist presented the lectures, which were followed immediately by a questionnaire and 4 months later by a telephone call.
Of the 80% of attendees who had never undergone any CRC screening test, only 18% reported family physician recommendations for such tests. Eighty-four percent reported willingness to undergo fecal occult blood testing and 52% to undergo colonoscopy; 62% replied that they should undergo some CRC screening test and 90% believed that these tests save lives. Of the women, 47% expressed preference for a female gastroenterologist. Follow-up showed that 34% proceeded to undergo some CRC screening test: 60% chose colonoscopy and 40% FOBT.
Public lectures are effective in improving compliance with the CRC screening test. Physicians should recommend these tests to appropriate individuals. Same-gender gastroenterologists should be considered for individuals uneasy about someone from the opposite gender performing the test. Assessing the various health-promotion efforts can direct us in implementing finite resources to greatest effect. Local cancer institutes and societies may be supportive in disseminating screening information in this way.
以色列结直肠癌筛查测试的频率很低，远低于美国。这种低比率归因于卫生系统的缺陷以及医生和患者双方的障碍。
进一步确定具体的卫生系统缺陷、基于医生和患者的障碍，以及公开讲座在提高结直肠癌筛查测试执行频率方面的效果。
举办了关于结直肠癌预防的公开讲座。由一名胃肠病学家进行讲座，讲座后立即进行问卷调查，4个月后进行电话随访。
在从未接受过任何结直肠癌筛查测试的80%的参与者中，只有18%报告家庭医生曾建议他们进行此类测试。84%的参与者表示愿意接受粪便潜血检测，52%愿意接受结肠镜检查；62%回答他们应该接受某种结直肠癌筛查测试，90%认为这些测试能挽救生命。在女性参与者中，47%表示更倾向于由女性胃肠病学家进行检查。随访显示，34%的参与者随后进行了某种结直肠癌筛查测试：60%选择了结肠镜检查，40%选择了粪便潜血检测。
公开讲座在提高结直肠癌筛查测试的依从性方面是有效的。医生应向合适的个体推荐这些测试。对于对异性进行检查感到不安的个体，应考虑安排同性别的胃肠病学家。评估各种健康促进措施可以指导我们以最有效的方式利用有限的资源。当地的癌症机构和协会可能有助于以这种方式传播筛查信息。
