Quebec breast cancer screening program: a study of the perceptions of physicians in Laval, Que.

OBJECTIVE

To identify physicians' perceptions of breast cancer prevention in order to generate strategies to increase women's participation in the Quebec breast cancer screening program (QBCSP).

DESIGN

Qualitative study using archival data and in-depth interviews.

SETTING

Laval, Que, a suburban city north of Montreal.

PARTICIPANTS

Twenty family physicians and 1 gynecologist practising in Laval who had received at least 1 screening mammography report in 2004 or 2005.

METHODS

Archival data were obtained in order to refine our understanding of the QBCSP. In-depth individual interviews were conducted with participating physicians until data saturation was reached in order to determine physicians' knowledge of, beliefs and attitudes about, and behaviour toward preventive breast cancer practices, as well as their suggestions for enhancing patient compliance. The interviews were recorded, transcribed, and coded, and the content was analyzed.

MAIN FINDINGS

Respondents indicated that the screening age groups, the age for beginning clinical breast examination, and the instructions to patients about breast self-examination should be harmonized. Letters to patients should be shortened, simplified, and endorsed by physicians. Screening mammography reports should include more details and be clearer about patient follow-up. The need for patients to sign authorization forms for transmission of information related to their participation in the QBCSP should be reinforced by their physicians. Following abnormal mammogram results, services and procedures should be simplified and delays in appointments decreased. Referral for "orphan patients" (ie, patients without family physicians) should be supervised by nurse practitioners, with physician consultations when needed.

CONCLUSION

This study provides a qualitative understanding of improvements or modifications needed in order to reach a screening mammography participation rate sufficient to reduce breast cancer mortality in women.