卡塔尔国一家三级医疗中心的乳腺癌筛查实践：一项横断面调查。
Breast Cancer Screening Practices in a Tertiary Care Center in the State of Qatar: A Cross-Sectional Survey.
作者信息
Parambil Jessiya Veliyankodan, Najim Mostafa, Mahmoud Mohamed, Abubeker Ibrahim Yusuf, Kartha Anand, Calaud Francois, Al-Mohamed Ahmed, Al-Mohannadi Dabia, Chandra Prem, A Yassin Mohamed
机构信息
Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Internal Medicine, Brown University, Providence, Rhode Island, USA.
出版信息
Breast Cancer (Dove Med Press). 2021 Jan 8;13:21-30. doi: 10.2147/BCTT.S285210. eCollection 2021.
INTRODUCTION
Breast cancer is the most common cancer in females. In Qatar, mortality related to breast cancer came in third after lung cancer and leukemia. In this study, we aim to comprehensively evaluate the rate of internal medicine residents and faculty compliance with breast cancer screening in Hamad Medical Corporation (Doha, Qatar), as well as to identify barriers and facilitators that could potentially augment changes to enhance physician-led cancer screening.
METHODS
A cross-sectional web-based survey was distributed among internal medicine physicians between December 2018 and March 2019 at a tertiary medical centre. It focused on the knowledge, attitude, and practice of physicians regarding breast cancer screening guidelines and explored potential barriers and proposed solutions. Chi-square and -test statistics were used to draw conclusions where appropriate.
RESULTS
A total of 158 physicians responded to the survey, with a response rate of 61%. 75.9% were postgraduate trainees. Around three-quarters of the physicians mentioned that they would recommend breast cancer screening for their age-appropriate average-risk patients. There was a statistically significant difference between the trainees, consultants, and specialists regarding the modality of choice, where the majority of the trainees opted mammogram every 2 or 3 years while 44.4% of the consultants indicated yearly self-breast exam (<0.001). The percentage of survey participants who rarely to never offer breast cancer screening in the outpatient settings was 37.8%. Unclear pathway (40%) and lack of time in clinic/ward rounds (26.5%) were the major reported barriers for cancer screening.
CONCLUSION
In the current era of personalized medicine, physicians should be more oriented to local guidelines to provide optimal care to their patients. While the attitude towards breast cancer screening is positive, the overall compliance with the national recommendations is sub-optimal. Further initiatives and intervention programs are required to promote the breast cancer screening in Qatar.
引言
乳腺癌是女性中最常见的癌症。在卡塔尔，与乳腺癌相关的死亡率仅次于肺癌和白血病，位居第三。在本研究中，我们旨在全面评估哈马德医疗公司（卡塔尔多哈）内科住院医师和教职员工对乳腺癌筛查的依从率，同时识别可能有助于推动变革以加强医生主导的癌症筛查的障碍和促进因素。
方法
2018年12月至2019年3月期间，在一家三级医疗中心对内科医生开展了一项基于网络的横断面调查。该调查聚焦于医生对乳腺癌筛查指南的知识、态度和实践，并探讨了潜在障碍及提出的解决方案。在适当情况下使用卡方检验和t检验统计得出结论。
结果
共有158名医生回复了调查，回复率为61%。75.9%为研究生学员。约四分之三的医生表示，他们会为年龄合适、平均风险的患者推荐乳腺癌筛查。在选择的筛查方式上，学员、顾问和专家之间存在统计学显著差异，大多数学员选择每2或3年进行一次乳房X光检查，而44.4%的顾问表示每年进行一次自我乳房检查（<0.001）。在门诊环境中很少或从不提供乳腺癌筛查的调查参与者比例为37.8%。路径不明确（40%）和临床/查房时间不足（26.5%）是报告的癌症筛查的主要障碍。
结论
在当前个性化医疗时代，医生应更遵循当地指南，为患者提供最佳护理。虽然对乳腺癌筛查的态度是积极的，但总体上对国家建议的依从性仍不理想。需要进一步采取举措和干预项目来促进卡塔尔的乳腺癌筛查。
Zotero 插件