Heywood A, Sanson-Fisher R, Ring I, Mudge P
Epidemiology and Health Information Branch, Queensland Health, Brisbane, Australia.
Prev Med. 1994 Mar;23(2):152-9. doi: 10.1006/pmed.1994.1021.
This study presents cancer risk prevalence and screening rates of patients attending general practitioners. Conditions addressed include smoking, skin cancer, Pap smears, clinical breast examinations, and mammography.
A cross-sectional study of 7,160 patients 18-75 years presenting to 230 general practitioners in a metropolitan and country region in Queensland, Australia, was used. Risk prevalence was assessed from patients' self-report of risk behaviors and screening prior to the consultation. Details of preventive care provided in the consultation were based on doctors' self-report at the conclusion of the consultation.
Twenty-seven percent of men and 23% of women smoked, rates being highest in the younger age groups. Using national guidelines, prior screening had not occurred as recommended for men and women as follows: skin cancer screening--66% of men, 70% of women; cervical cancer screening--27%; clinical breast examination--45%; mammography--75%. These patients were thus categorized as "at risk," and screening rates for these patients in the consultation were as follows: smokers--34%; skin cancer--5%; cervical cancer--16%; mammography--4%; clinical breast examination--8%.
Significant numbers of patients presenting to general practitioners were at risk of developing cancer, according to national guidelines. Of these, only small proportions of all groups had a preventive intervention by their GP at the consultation identified in this study. While GPs generally see their role in prevention as important, these results raise questions for future cancer prevention policies and training of GPs.
本研究呈现了就诊于全科医生的患者的癌症风险患病率及筛查率。涉及的情况包括吸烟、皮肤癌、巴氏涂片检查、临床乳腺检查和乳房X光检查。
采用横断面研究，对澳大利亚昆士兰州一个大都市和乡村地区的230名全科医生处就诊的7160名18 - 75岁患者进行研究。风险患病率通过患者在就诊前对风险行为和筛查的自我报告进行评估。就诊时提供的预防保健细节基于医生在就诊结束时的自我报告。
27%的男性和23%的女性吸烟，吸烟率在较年轻年龄组中最高。按照国家指南，男性和女性此前未按推荐进行如下筛查：皮肤癌筛查——男性为66%，女性为70%；宫颈癌筛查——27%；临床乳腺检查——45%；乳房X光检查——75%。因此，这些患者被归类为“有风险”，这些患者在就诊时的筛查率如下：吸烟者——34%；皮肤癌——5%；宫颈癌——16%；乳房X光检查——4%；临床乳腺检查——8%。
根据国家指南，大量就诊于全科医生的患者有患癌风险。在这些患者中，本研究确定在就诊时只有小部分所有组别的患者接受了全科医生的预防性干预。虽然全科医生普遍认为他们在预防方面的作用很重要，但这些结果为未来的癌症预防政策和全科医生培训提出了问题。
