探索性研究：初级保健临床医生对 2021 年新癌症筛查指南和更新癌症筛查指南的看法。
An Exploratory Study of Primary Care Clinicians' Perspectives on 2021 New and Updated Cancer Screening Guidelines.
机构信息
Oregon Health & Science University, Portland, OR, USA.
Fred Hutchinson Cancer Center, Seattle, WA, USA.
出版信息
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231164910. doi: 10.1177/21501319231164910.
BACKGROUND AND OBJECTIVE
Cancer screening rates remain low in rural, racial and ethnic minority, low-income, and uninsured populations. Prior studies showed that cancer screening recommendations vary based on clinicians' factors. We conducted an exploratory study on primary care clinicians' beliefs about new or updated cancer screening guidelines according to clinician demographics.
METHODS
This cross-sectional study involved administering a web-based survey in July and August of 2021 to primary care clinicians practicing in diverse ambulatory settings in the Pacific Northwest belonging to the same health system. The survey assessed clinician demographics, attitudes about the impact of cancer screening on mortality, and how clinicians stay up-to-date with guidelines.
RESULTS
Of the 191 clinicians, 81 responded (42.4%), after removing 13 incomplete surveys, we analyzed 68 (35.6%). The majority agreed/strongly agreed that breast (76.1%), colorectal (95.5%), and cervical (90.9%) cancer screening, and HPV vaccination (85.1%) prevent early cancer mortality: there were no differences according to clinician gender or years in practice. Female compared to male clinicians were more likely to agree/strongly agree that tobacco smoking cessation (female: 100% vs male: 86.4%, = .01) prevents early cancer mortality, whereas male compared to female clinicians were more likely to agree/strongly agree that lung cancer screening (male: 86.4% vs female: 57.8%, = .04) prevents early cancer mortality. One-third (33.3%) of clinicians were unaware of the 2021 update on lung cancer screening and females were more likely than males to say they did not know about this change (females: 43.2% vs males: 13.6%, = .02).
CONCLUSIONS
This study suggests that clinicians' attitudes are not likely the primary factor affecting low cancer screening rates in some populations and that few differences exist in beliefs based on gender, and none based on years in practice.
背景和目的
癌症筛查率在农村、种族和少数民族、低收入和没有保险的人群中仍然较低。先前的研究表明，癌症筛查建议因临床医生的因素而异。我们根据临床医生的人口统计学特征，对初级保健临床医生对新的或更新的癌症筛查指南的信念进行了一项探索性研究。
方法
这项横断面研究于 2021 年 7 月至 8 月，向在属于同一医疗系统的多样化门诊环境中执业的太平洋西北地区的初级保健临床医生，在线发放调查问卷。该调查评估了临床医生的人口统计学特征、对癌症筛查对死亡率影响的态度，以及临床医生如何了解最新指南。
结果
在 191 名临床医生中，有 81 名（42.4%）人做出了回应。在剔除 13 份不完整的调查问卷后，我们对 68 份（35.6%）进行了分析。大多数人同意/强烈同意乳腺癌（76.1%）、结直肠癌（95.5%）和宫颈癌（90.9%）筛查，以及 HPV 疫苗接种（85.1%）可以预防早期癌症死亡：根据临床医生的性别或从业年限，没有差异。与男性临床医生相比，女性临床医生更有可能同意/强烈同意戒烟（女性：100%对男性：86.4%， = .01）可预防早期癌症死亡，而与女性相比，男性临床医生更有可能同意/强烈同意肺癌筛查（男性：86.4%对女性：57.8%， = .04）可预防早期癌症死亡。三分之一（33.3%）的临床医生不知道 2021 年肺癌筛查更新，女性比男性更有可能表示不知道这一变化（女性：43.2%对男性：13.6%， = .02）。
结论
这项研究表明，在某些人群中，临床医生的态度可能不是导致癌症筛查率低的主要因素，而且基于性别，在信念上没有差异，也没有基于从业年限的差异。
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