INTRODUCTION: The Canadian Task Force on Preventive Health Care (CTF-PHC) recently revised its screening recommendations for colorectal cancer (CRC). We wished to assess the effect of this change on the screening beliefs and clinical practice of primary care physicians. METHODS: We surveyed 160 primary-care physicians, quasi-randomly sampled, in June-July 2001 and again in April-July 2002, 9 months after publication of the guidelines. Descriptive statistics and McNemar chi2 analyses were carried out on data from physicians who responded to both surveys. RESULTS: Of the those sampled, 47% responded to both surveys. After the publication of the CTF-PHC guidelines, the proportion reporting that they recommend CRC screening to their patients at average risk increased from 43% to 60% (p = 0.02). Before publication of the revised guidelines 48% stated that the CTF-PHC did not support screening, compared with 24% afterward (p = 0.01). CTF-PHC guidelines were acknowledged by 30% to be a source of CRC screening information. Around 9 months post-publication, 24% of the physicians stated their awareness of the revised screening guidelines. The most commonly cited reasons for not recommending CRC screening to average-risk patients were that the evidence is inconclusive and that CTF-PHC guidelines do not support screening. CONCLUSIONS: After publication of the revised CTF-PHC guidelines more primary-care physicians reported that they recommend CRC screening to their average-risk patients. The belief that the evidence is inconclusive nevertheless remains a considerable barrier to implementation. To increase the use of screening for CRC, additional strategies are required.
INTRODUCTION: The Canadian Task Force on Preventive Health Care (CTF-PHC) recently revised its screening recommendations for colorectal cancer (CRC). We wished to assess the effect of this change on the screening beliefs and clinical practice of primary care physicians. METHODS: We surveyed 160 primary-care physicians, quasi-randomly sampled, in June-July 2001 and again in April-July 2002, 9 months after publication of the guidelines. Descriptive statistics and McNemar chi2 analyses were carried out on data from physicians who responded to both surveys. RESULTS: Of the those sampled, 47% responded to both surveys. After the publication of the CTF-PHC guidelines, the proportion reporting that they recommend CRC screening to their patients at average risk increased from 43% to 60% (p = 0.02). Before publication of the revised guidelines 48% stated that the CTF-PHC did not support screening, compared with 24% afterward (p = 0.01). CTF-PHC guidelines were acknowledged by 30% to be a source of CRC screening information. Around 9 months post-publication, 24% of the physicians stated their awareness of the revised screening guidelines. The most commonly cited reasons for not recommending CRC screening to average-risk patients were that the evidence is inconclusive and that CTF-PHC guidelines do not support screening. CONCLUSIONS: After publication of the revised CTF-PHC guidelines more primary-care physicians reported that they recommend CRC screening to their average-risk patients. The belief that the evidence is inconclusive nevertheless remains a considerable barrier to implementation. To increase the use of screening for CRC, additional strategies are required.
Authors: J D Hardcastle; J O Chamberlain; M H Robinson; S M Moss; S S Amar; T W Balfour; P D James; C M Mangham Journal: Lancet Date: 1996-11-30 Impact factor: 79.321
Authors: Maida J Sewitch; Pascal Burtin; Martin Dawes; Mark Yaffe; Linda Snell; Mark Roper; Patrizia Zanelli; Alan Pavilanis Journal: Can J Gastroenterol Date: 2006-11 Impact factor: 3.522