Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
BMC Fam Pract. 2010 Mar 9;11:20. doi: 10.1186/1471-2296-11-20.
Colorectal cancer (CRC) is the third most common cancer in the UK. Five-year survival rates are less than 50%, largely because of late diagnosis. Screening using faecal occult blood tests (FOBt) can detect bowel cancer at an earlier stage than symptomatic presentation, and has the potential to significantly decrease colorectal cancer mortality. However, uptake of screening is currently low, despite the introduction of the NHS Bowel Cancer Screening Programme (NHSBCSP), and it has been suggested that GP recommendations of screening can improve patient compliance. GP recommendation of CRC screening is argued to be affected by attitudes towards it, along with perceptions of its efficacy.
This paper presents the findings of a cross-sectional postal survey of GPs in the UK which aimed to investigate GPs' attitudes in relation to colorectal cancer screening and the use of FOBt in routine practice. An 'attitude' score was calculated, and binary logistic regression used to evaluate the association of socio-demographic and general practice attributes with attitudes towards CRC screening and FOBt.
Of 3,191 GPs surveyed, 960 returned usable responses (response rate 30.7%). Positive attitudes were associated with personal experience of CRC screening and Asian or Asian British ethnicity. GPs from practices located in more deprived locations were also more likely to have positive attitudes towards FOBt and its recommendation to patients.
The success of population-based screening for CRC will largely be determined by GP attitudes and support, particularly with regard to FOBt. Previous research has implied that South Asian GPs are more likely to have negative attitudes towards FOBt screening, however, our research suggests that this is not a group requiring targeted interventions to increase their support for the NHSBCSP. Of the available CRC screening tests, GPs perceived FOBt to be the most appropriate for population-based screening.
结直肠癌（CRC）是英国第三大常见癌症。五年生存率低于 50%，主要原因是诊断较晚。粪便潜血试验（FOBt）筛查可在症状出现前更早地发现肠癌，并有可能显著降低结直肠癌死亡率。然而，尽管 NHS 肠癌筛查计划（NHSBCSP）已经推出，目前筛查的参与率仍然很低，有人认为全科医生对筛查的建议可以提高患者的依从性。有人认为，全科医生对 CRC 筛查的推荐受到对其的态度以及对其疗效的看法的影响。
本文介绍了一项针对英国全科医生的横断面邮寄调查的结果，该调查旨在调查全科医生对结直肠癌筛查的态度以及在常规实践中使用 FOBt 的情况。计算了“态度”评分，并使用二元逻辑回归评估了社会人口统计学和一般实践特征与对 CRC 筛查和 FOBt 的态度之间的关联。
在调查的 3191 名全科医生中，有 960 名返回了可用的回复（回应率为 30.7%）。积极的态度与个人接受 CRC 筛查的经验以及亚裔或亚裔英国人的种族有关。来自位于较贫困地区的实践的全科医生也更有可能对 FOBt 及其向患者推荐持积极态度。
基于人群的 CRC 筛查的成功将在很大程度上取决于全科医生的态度和支持，特别是对于 FOBt。先前的研究表明，南亚裔全科医生对 FOBt 筛查的态度可能更消极，但我们的研究表明，这并不是一个需要有针对性的干预措施来增加他们对 NHSBCSP 支持的群体。在可用的 CRC 筛查测试中，全科医生认为 FOBt 最适合基于人群的筛查。
