Lynn Brenna, Hatry Alexandra, Burnett Chloe, Kan Lisa, Olatunbosun Tunde, Bluman Bob
Division of Continuing Professional Development, Faculty of Medicine, University of British Columbia, VGH JPPN 3300, 910 W 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
Continuing Medical Education and Professional Development, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
J Cancer Educ. 2018 Dec;33(6):1255-1262. doi: 10.1007/s13187-017-1240-5.
Population-based cancer screening for cervical, breast, and colorectal cancers improves patient outcomes, yet screening rates remain low for some cancers. Despite studies investigating physician perceptions and practices for screening, many have focused on individual cancers and lack primary care physicians' (PCPs) realities around screening for multiple cancers. We surveyed 887 PCPs in British Columbia (BC) to examine practices, beliefs, barriers, and learning needs towards cancer screening across breast, cervical, colorectal, prostate, as well as hereditary predisposition to cancer. Survey results identified differences in PCPs belief in the benefit of screening for recommended and non-recommended routine cancer screening, PCPs adherence to screening guidelines for some cancers and physician comfort and patient testing requests related to physician gender for gender sensitive tests. Further, across cancers, screening barriers included patients with multiple health concerns (41%), limited time to discuss screening (36%), and lack of physician financial compensation to discuss screening (23%). The study highlighted the need for more physician education on screening programs, referral criteria, follow-up processes, and screening guidelines. Conferences (73%), self-directed (46%), small group workshops (42%), hospital rounds (41%), and online CME/CPD (39%) were highly preferred (4+5) for learning about cancer screening. The results suggest a need to improve awareness and adherence to screening guidelines and recommended practices, as well as to provide educational opportunities which address knowledge and practice gaps for physicians.
基于人群的宫颈癌、乳腺癌和结直肠癌筛查可改善患者预后，但某些癌症的筛查率仍然较低。尽管有研究调查医生对筛查的看法和做法，但许多研究都集中在单一癌症上，缺乏对初级保健医生（PCP）在多种癌症筛查方面实际情况的研究。我们对不列颠哥伦比亚省（BC）的887名初级保健医生进行了调查，以研究他们在乳腺癌、宫颈癌、结直肠癌、前列腺癌筛查以及癌症遗传易感性方面的做法、信念、障碍和学习需求。调查结果显示，初级保健医生在对推荐和非推荐的常规癌症筛查益处的信念、对某些癌症筛查指南的遵守情况以及与性别敏感检查相关的医生舒适度和患者检查请求方面存在差异。此外，在各种癌症中，筛查障碍包括有多种健康问题的患者（41%）、讨论筛查的时间有限（36%）以及缺乏医生讨论筛查的经济补偿（23%）。该研究强调需要对医生进行更多关于筛查项目、转诊标准、后续流程和筛查指南的教育。会议（73%）、自主学习（46%）、小组研讨会（42%）、医院查房（41%）和在线继续医学教育/持续专业发展（39%）是学习癌症筛查最受欢迎的方式（4+5）。结果表明，有必要提高对筛查指南和推荐做法的认识与遵守程度，并提供教育机会以弥补医生的知识和实践差距。
