Département de médecine générale, Denis Diderot University Paris 7, 16 rue Henri, Huchard 75018, Paris, France.
Fam Pract. 2011 Dec;28(6):670-6. doi: 10.1093/fampra/cmr020. Epub 2011 May 6.
The faecal occult blood test (FOBT) has proven efficiency at screening populations for an average risk of colorectal cancer. Mortality related to this cancer decreases by 15-18% among adults, 50-74 years old, tested every 2 years. A participation rate of at least 50% is desirable. This rate has not yet been reached in most French regions.
To explore the obstacles to mass colorectal screening in France.
In 2009, five focus groups were conducted in different areas to explore physicians' obstacles to FOBT screening. The patients' obstacles were assessed in semi-structured interviews. A purposive sampling had been carried out for both GPs and patients. The focus groups were coded using Nvivo 8(®) software by three researchers; the interviews manually coded by two researchers.
GPs reported insufficient training and some doubted the relevance of screening. They expressed concern of having insufficient time for the test during a consultation, as well as practical and administrative obstacles. Some GPs experienced difficulty persuading patients who had no signs of colorectal disease. Obstacles for patients were mainly difficulties in doing screening themselves and a perception of health care that didn't match with screening. Information and organization were also important points to improve. The screening process was considered complex both by GPs and by patients.
Numerous obstacles to colorectal screening, from both the physicians' and the patients' perspectives, were found. The major goal to improve mass screening may be to increase awareness and understanding of both physicians and patients regarding this process.
粪便潜血试验（FOBT）已被证明可有效用于筛查普通人群的结直肠癌风险。50-74 岁的成年人每两年接受一次测试，可使该癌症的死亡率降低 15-18%。期望参与率至少达到 50%。但在法国大多数地区，尚未达到这一水平。
探索法国大规模结直肠癌筛查的障碍。
2009 年，在不同地区进行了五次焦点小组讨论，以探讨医生进行 FOBT 筛查的障碍。通过半结构化访谈评估患者的障碍。对全科医生和患者进行了有针对性的抽样。使用 Nvivo 8(®)软件对焦点小组进行了三位研究人员的编码；访谈由两位研究人员手动编码。
全科医生报告说培训不足，一些人怀疑筛查的相关性。他们表示担心在咨询期间没有足够的时间进行测试，还存在实际和行政方面的障碍。一些全科医生在说服没有结直肠疾病迹象的患者方面存在困难。患者的障碍主要是自行进行筛查的困难以及对医疗保健的看法与筛查不符。信息和组织也是需要改进的重点。筛查过程被认为既复杂又复杂全科医生和患者。
从医生和患者的角度发现了许多结直肠癌筛查的障碍。提高大规模筛查的主要目标可能是提高医生和患者对这一过程的认识和理解。
