Division of General and Gastrointestinal Surgery, Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Division of Cancer Medicine, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
JCO Glob Oncol. 2024 Aug;10:e2400053. doi: 10.1200/GO.24.00053.
This study aims to identify the factors influencing colorectal cancer (CRC) screening practices, along with the barriers and facilitators from the perspective of primary care physicians (PCPs) in Ukraine. Considering health care system challenges, including those posed by the ongoing war, this research seeks to inform improvements in CRC screening and outcomes in Ukraine and other low- and middle-income countries (LMICs).
A survey was designed and distributed electronically to Ukrainian PCPs, focusing on CRC screening practices, beliefs, and barriers. The survey incorporated questions adapted from established cancer screening surveys and frameworks. Complete responses were collected from 740 PCPs. Sample statistics were computed, and population-level perceptions and associations with CRC screening practices were estimated by standardizing responses to national PCP demographics.
The majority of respondents were women (91%) and specialized in family medicine (84%). Respondents believed in the effectiveness of colonoscopy for reducing CRC mortality (80%), with 75% of PCPs referring patients for this screening modality. Major barriers identified include inadequate training of PCPs in screening and lack of resources. Respondents reported high utilization of fecal occult blood test and colonoscopy for screening when these tests were said to be available in their practices. Self-reported familiarity with CRC screening guidelines and participation in educational workshops were positively associated with screening referrals.
The study highlights the role of access to CRC screening tests and awareness of screening guidelines in enhancing CRC screening practices among Ukrainian PCPs. Addressing training and resource barriers, alongside public health interventions targeting patient-related barriers, is essential. These findings offer valuable insights for LMICs facing similar challenges, emphasizing the need for tailored strategies to improve cancer screening in these health care settings.
本研究旨在确定影响乌克兰初级保健医生（PCP）进行结直肠癌（CRC）筛查的因素，以及他们对筛查的看法、障碍和促进因素。考虑到医疗保健系统的挑战，包括正在进行的战争带来的挑战，本研究旨在为改善乌克兰和其他低收入和中等收入国家（LMIC）的 CRC 筛查和结果提供信息。
我们设计了一份电子调查问卷，向乌克兰 PCP 调查 CRC 筛查实践、信念和障碍。调查问卷采用了来自已建立的癌症筛查调查和框架的问题。共收到 740 名 PCP 的完整回复。计算了样本统计数据，并通过将回复标准化为全国 PCP 人口统计学数据，估计了人口水平的看法和与 CRC 筛查实践的关联。
大多数受访者为女性（91%），专业为家庭医学（84%）。受访者认为结肠镜检查对降低 CRC 死亡率有效（80%），75%的 PCP 会将患者转诊进行这种筛查。主要障碍包括 PCP 筛查培训不足和资源缺乏。受访者报告说，在他们的实践中，如果有粪便潜血试验和结肠镜检查可用，他们会大量使用这些检查进行筛查。自我报告对 CRC 筛查指南的熟悉程度和参加教育研讨会与筛查转诊呈正相关。
本研究强调了获得 CRC 筛查测试和了解筛查指南在提高乌克兰 PCP 进行 CRC 筛查实践中的作用。解决培训和资源障碍，以及针对患者相关障碍的公共卫生干预措施，是至关重要的。这些发现为面临类似挑战的 LMIC 提供了有价值的见解，强调了需要制定有针对性的策略来改善这些医疗保健环境中的癌症筛查。
