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医生对癌症筛查测试有效性的看法:一项针对家庭医生、普通内科医生和妇产科医生的全国性调查。

Physicians' beliefs about effectiveness of cancer screening tests: a national survey of family physicians, general internists, and obstetrician-gynecologists.

作者信息

Miller Jacqueline W, Baldwin Laura-Mae, Matthews Barbara, Trivers Katrina F, Andrilla C Holly, Lishner Denise, Goff Barbara A

机构信息

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Department of Family Medicine, University of Washington, Seattle, WA, USA.

出版信息

Prev Med. 2014 Dec;69:37-42. doi: 10.1016/j.ypmed.2014.07.009. Epub 2014 Jul 17.

Abstract

OBJECTIVE

To study physicians' beliefs about the effectiveness of different tests for cancer screening.

METHODS

Data were examined from the Women's Health Survey of 1574 Family Medicine, Internal Medicine, and Obstetrics-Gynecology physicians to questions about their level of agreement about the clinical effectiveness of different tests for breast, cervical, ovarian, and colorectal cancer screening among average risk women. Data were weighted to the U.S. physician population based on the American Medical Association Masterfile. Multivariable logistic regression identified physician and practice characteristics significantly associated with physicians' beliefs.

RESULTS

There were 1574 respondents, representing a 62% response rate. The majority of physicians agreed with the effectiveness of mammography for women aged 50-69years, Pap tests for women aged 21-65years, and colonoscopy for individuals aged ≥50years. A substantial proportion of physicians believed that non-recommended tests were effective for screening (e.g., 34.4% for breast MRI and 69.1% for annual pelvic exam). Physicians typically listed their respective specialty organizations as a top influential organization for screening recommendations.

CONCLUSIONS

There were several substantial inconsistencies between physician beliefs in the effectiveness of cancer screening tests and the actual evidence of these tests' effectiveness which can lead both to underuse and overuse of cancer screening tests.

摘要

目的

研究医生对不同癌症筛查检测有效性的看法。

方法

对1574名家庭医学、内科和妇产科医生进行的女性健康调查数据进行分析,这些数据涉及他们对普通风险女性进行乳腺癌、宫颈癌、卵巢癌和结直肠癌筛查的不同检测临床有效性的认同程度。根据美国医学协会主文件,数据按美国医生总体情况进行加权。多变量逻辑回归确定了与医生看法显著相关的医生及执业特征。

结果

有1574名受访者,回复率为62%。大多数医生认同50 - 69岁女性进行乳房X线摄影、21 - 65岁女性进行巴氏试验以及≥50岁个体进行结肠镜检查的有效性。相当一部分医生认为未被推荐的检测对筛查有效(例如,34.4%认为乳腺磁共振成像有效,69.1%认为每年进行盆腔检查有效)。医生通常将各自的专业组织列为筛查建议的最具影响力组织。

结论

医生对癌症筛查检测有效性的看法与这些检测有效性的实际证据之间存在一些重大不一致,这可能导致癌症筛查检测的使用不足和过度使用。

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