Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland.
Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg, Havel, Germany.
Cancer Prev Res (Phila). 2021 Feb;14(2):205-214. doi: 10.1158/1940-6207.CAPR-20-0407. Epub 2020 Oct 6.
As clinical guidelines for cancer prevention refer individuals to primary care physicians (PCP) for risk assessment and clinical management, PCPs may be expected to play an increasing role in cancer prevention. It is crucial that PCPs are adequately supported to assess an individual's cancer risk and make appropriate recommendations. The objective of this study is to assess use, familiarity, attitude, and behaviors of PCPs regarding breast and ovarian cancer risk and prevention, to better understand the factors that influence their prescribing behaviors. We conducted a cross-sectional, web-based survey of PCPs in the United States, recruited from an opt-in healthcare provider panel. Invitations were sent in batches until the target sample size of 750 respondents (250 each for obstetrics/gynecology, internal medicine, and family medicine) was met. Self-reported use of breast/ovarian cancer risk assessments was low (34.7%-59.2%) compared with discussion of cancer family history (96.9%), breast exams (87.1%), and mammograms (92.8%). Although most respondents (48.0%-66.8%) were familiar with cancer prevention interventions, respondents who reported to be less familiar were more likely to report cautious attitudes. When presented with hypothetical cases depicting patients at different breast/ovarian cancer risks, up to 34.0% of respondents did not select any of the clinically recommended course(s) of action. This survey suggests that PCP use of breast/ovarian cancer risk assessment tools and ability to translate the perceived risks to clinical actions is variable. Improving implementation of cancer risk assessment and clinical management guidelines within primary care may be necessary to improve the appropriate prescribing of cancer prevention interventions. Primary care physicians are becoming more involved in cancer prevention management, so it is important that cancer risk assessment and medical society guideline recommendations for cancer prevention are better integrated into primary care to improve appropriate prescribing of cancer prevention interventions and help reduce cancer risk.
由于癌症预防临床指南将个体转介给初级保健医生（PCP）进行风险评估和临床管理，因此 PCP 可能会在癌症预防中发挥越来越重要的作用。至关重要的是，应充分支持 PCP 评估个体的癌症风险并提出适当的建议。本研究旨在评估 PCP 对乳腺癌和卵巢癌风险和预防的使用、熟悉程度、态度和行为，以更好地了解影响其处方行为的因素。我们对美国的 PCP 进行了横断面、基于网络的调查，这些 PCP 是从选择加入的医疗保健提供者小组中招募的。邀请分批发送，直到达到 750 名受访者（每个妇产科、内科和家庭医学组 250 名）的目标样本量。与讨论癌症家族史（96.9%）、乳房检查（87.1%）和乳房 X 光检查（92.8%）相比，自我报告的使用乳腺癌/卵巢癌风险评估的比例较低（34.7%-59.2%）。尽管大多数受访者（48.0%-66.8%）熟悉癌症预防干预措施，但报告熟悉程度较低的受访者更有可能持谨慎态度。当呈现描述不同乳腺癌/卵巢癌风险的假设病例时，多达 34.0%的受访者未选择任何临床推荐的行动方案。这项调查表明，PCP 使用乳腺癌/卵巢癌风险评估工具和将感知风险转化为临床行动的能力各不相同。改善初级保健中癌症风险评估和临床管理指南的实施可能对于改善癌症预防干预措施的适当处方是必要的。初级保健医生越来越多地参与癌症预防管理，因此，将癌症风险评估和医学协会的癌症预防指南建议更好地纳入初级保健中，以改善癌症预防干预措施的适当处方，并有助于降低癌症风险，这一点非常重要。
