Boissel J P, Collet J P, Alborini A, Cordel J C, Filsnoel J, Gillet J, Nemoz C, Brémond A, Bernhard G, Bourdin J F
Service de Pharmacologie Clinique, Lyon.
Rev Epidemiol Sante Publique. 1995 Dec;43(6):541-7.
This study was aimed at evaluating the effects of an education program for general practitioners on their prescribing behaviour for cervical and breast cancer screening tests, and assessing the feasibility of general practitioners participation in screening programs. All three cytology laboratories and 19 of the 20 radiologists in one administrative region ("Haute-Savoie") in France agreed to participate. The 278 general practices in this region were randomly assigned to either the intervention group (a one-day seminar on screening for breast cancer and cervical cancer) or the control group (n for both = 139). The prescriptions of tests for the following year were noted from the laboratories' and radiologists' records. No significant differences were observed between the intervention group and the control group for the number of mammographies prescribed with a mean of 19.3 and 15.2 per practice, respectively. However, significantly more mammographies were prescribed in women aged over 50 by the intervention group (p = 0.038). Inversely, fewer smear tests were prescribed in the intervention group (mean per practice: 40.5 and 46.1, respectively). A significantly higher number of practices in the intervention group did not prescribe any smear tests (p = 0.007). This study suggests that it is possible to influence general practitioners' participation in screening programs, but that the messages should be carefully presented, since negative effects are possible.
本研究旨在评估一项针对全科医生的教育计划对其宫颈癌和乳腺癌筛查测试处方行为的影响，并评估全科医生参与筛查计划的可行性。法国一个行政区（“上萨瓦省”）的所有三个细胞学实验室以及20名放射科医生中的19名同意参与。该地区的278家全科诊所被随机分为干预组（关于乳腺癌和宫颈癌筛查的为期一天的研讨会）或对照组（两组n均为139）。从实验室和放射科医生的记录中记录下次年的测试处方情况。干预组和对照组之间，平均每家诊所开具的乳房X光检查数量分别为19.3次和15.2次，未观察到显著差异。然而，干预组为50岁以上女性开具的乳房X光检查显著更多（p = 0.038）。相反，干预组开具的涂片检查较少（平均每家诊所分别为40.5次和46.1次）。干预组中未开具任何涂片检查的诊所数量显著更多（p = 0.007）。本研究表明，有可能影响全科医生参与筛查计划，但信息的呈现应谨慎，因为可能会产生负面影响。
