Thanapirom Kessarin, Treeprasertsuk Sombat, Rerknimitr Rungsun
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Jul;95(7):859-65.
Colorectal cancer is one of the leading causes of cancer related death worldwide. Primary care physicians play an important role in colorectal cancer screening. However the awareness and knowledge on the methods for colorectal cancer screening are still lacking. The authors aimed to assess Thai primary care physicians' knowledge and practice regarding colorectal cancer screening.
Between October and December 2010, questionnaires were distributed to 447 Thai physicians. The questionnaires included demographic data, self-responded knowledge, and practice. Their responses were analyzed.
Three hundred eighty seven physicians completed the questionnaires (86.5% response rate). Of these, 44.7% were internists, 27.4% general practitioners (GPs), 11.9% surgeons, and 16.0% other specialists. Two hundred forty of physicians (62%) routinely recommended colorectal cancer screening to asymptomatic, average-risk patients. Only 43% gave the correct recommendation for the correct starting age. Colonoscopy (47.5%) and fecal occult blood test (40.0%) were preferred by the majority of physicians, whereas flexible sigmoidoscopy, double contrast barium enema, and CT colonoscopy were chosen by 5.7%, 4.4%, and 1.8% of physicians respectively. Surgeons had more knowledge of test efficacy and frequency. They also were more aware of colorectal cancer screening than internists. Patient ignorance (66.1%), unavailability of the test (64.6%), unawareness of physicians (57.9%), and financial problems (41.1%) were determinedas barriers for colorectal cancer screening.
Although the majority of physicians are aware of colorectal cancer screening, the correct knowledge is lacking. Colonoscopy and FOBT are their most preferred tests. Patient ignorance, unavailability of the test, unawareness of physician, and financial problems are the main barriers for colorectal cancer screening. Improvement in academic support services and standard clinical practice guideline are needed to improve overall morbidity and mortality of colorectal cancer.
结直肠癌是全球癌症相关死亡的主要原因之一。初级保健医生在结直肠癌筛查中发挥着重要作用。然而，对于结直肠癌筛查方法的认识和了解仍然不足。作者旨在评估泰国初级保健医生对结直肠癌筛查的知识和实践情况。
2010年10月至12月期间，向447名泰国医生发放了问卷。问卷包括人口统计学数据、自我回答的知识和实践情况。对他们的回答进行了分析。
387名医生完成了问卷（回复率为86.5%）。其中，44.7%是内科医生，27.4%是全科医生（GPs），11.9%是外科医生，16.0%是其他专科医生。240名医生（62%）常规向无症状的平均风险患者推荐结直肠癌筛查。只有43%的医生给出了正确的起始年龄推荐。大多数医生首选结肠镜检查（47.5%）和粪便潜血试验（40.0%），而分别有5.7%、4.4%和1.8%的医生选择了乙状结肠镜检查、双重对比钡灌肠和CT结肠镜检查。外科医生对检查效果和频率的了解更多。他们对结直肠癌筛查的认识也比内科医生更强。患者无知（66.1%）、无法进行检查（64.6%）、医生不了解（57.9%）和经济问题（41.1%）被确定为结直肠癌筛查的障碍。
虽然大多数医生了解结直肠癌筛查，但缺乏正确的知识。结肠镜检查和粪便潜血试验是他们最喜欢的检查方法。患者无知、无法进行检查、医生不了解和经济问题是结直肠癌筛查的主要障碍。需要改善学术支持服务和标准临床实践指南，以提高结直肠癌的总体发病率和死亡率。
