Brownson R C, Davis J R, Simms S G, Kern T G, Harmon R G
Division of Chronic Disease Prevention and Health Promotion, Missouri Department of Health, Columbia 65203.
J Cancer Educ. 1993 Spring;8(1):35-41. doi: 10.1080/08858199309528205.
Primary care physicians can play a key role in prevention and early detection of cancer. To assess cancer control knowledge and priorities among primary care physicians in Missouri, we conducted a random survey of 207 physicians. Although reported knowledge of the role tobacco plays in cancer causation was high, activity in tobacco cessation counselling and referral was low. Respondents considered diet to be a relatively unimportant factor in cancer causation, whereas they viewed sun exposure, genetics/family history, and radiation exposure as large contributors to the cancer burden. Among cancer early detection tests, high activity was shown for the Pap test and breast examination. Conversely, low activity was reported for colon sigmoidoscopy. Inverse correlations were shown between age group of the physician and several cancer prevention and early detection practices. For each cancer prevention and screening practice, reported activity was higher for medical doctors than for doctors of osteopathic medicine. Possible barriers or controversies in cancer control included disagreement with the current recommendation for Pap testing, the cost of mammography, and patient fear of sigmoidoscopy. These findings suggest that primary care physicians are not achieving their full potential in cancer control and indicate areas where increased emphasis is warranted.
初级保健医生在癌症预防和早期检测中可发挥关键作用。为评估密苏里州初级保健医生的癌症控制知识及重点，我们对207名医生进行了随机调查。尽管报告显示对烟草在癌症病因中所起作用的知晓率较高，但戒烟咨询和转诊活动却很少。受访者认为饮食在癌症病因中相对不太重要，而他们认为阳光照射、遗传/家族病史和辐射暴露是癌症负担的主要因素。在癌症早期检测测试中，巴氏试验和乳房检查的参与度较高。相反，乙状结肠镜检查的参与度较低。医生的年龄组与几种癌症预防和早期检测措施之间存在负相关。对于每种癌症预防和筛查措施，报告显示医学博士的参与度高于整骨医学博士。癌症控制中可能存在的障碍或争议包括对当前巴氏试验建议的不同意见、乳房X光检查的费用以及患者对乙状结肠镜检查的恐惧。这些发现表明，初级保健医生在癌症控制方面尚未充分发挥其潜力，并指出了需要加强重视的领域。
