BACKGROUND: Physician nonadherence to colorectal cancer (CRC) screening recommendations contributes to underuse of screening. OBJECTIVE: To assess physicians' knowledge of CRC screening guidelines for average-risk individuals, perceived barriers to screening and practice behaviours. METHODS: Between October 2004 and March 2005, staff physicians working in three university-affiliated hospitals in Montreal, Quebec, were surveyed. Self-administered questionnaires assessed knowledge of risk classification and current guidelines for average-risk individuals, as well as perceptions of barriers to screening and practice behaviours. RESULTS: All 65 invited physicians participated in the survey, including 46 (70.8%) family medicine physicians and 19 (29.2%) general internists. Most physicians knew that screening should begin at 50 years of age, all knew to screen men and women and 92% said they screened average-risk patients. Fifty-seven (87.7%) physicians correctly identified three common characteristics associated with high risk for developing CRC. Physicians who screened average-risk patients preferred fecal occult blood testing (88.3%) and colonoscopy (88.3%) to flexible sigmoidoscopy (10.0%) and double-contrast barium enema (30.0%). Most physicians knew the correct screening periodicity for fecal occult blood testing (87.6%), but only 40% or fewer could identify correct screening periodicities for the other modalities. Barriers and facilitators focused on health care delivery system improvements, better evidence on which to base recommendations and development of practical screening modalities. CONCLUSIONS: Physicians lacked knowledge of the recommended screening modalities and periodicities to appropriately screen average-risk individuals. Because CRC screening can reduce mortality, efforts to improve physician delivery should focus on physician knowledge and changes to the health care delivery system.
BACKGROUND: Physician nonadherence to colorectal cancer (CRC) screening recommendations contributes to underuse of screening. OBJECTIVE: To assess physicians' knowledge of CRC screening guidelines for average-risk individuals, perceived barriers to screening and practice behaviours. METHODS: Between October 2004 and March 2005, staff physicians working in three university-affiliated hospitals in Montreal, Quebec, were surveyed. Self-administered questionnaires assessed knowledge of risk classification and current guidelines for average-risk individuals, as well as perceptions of barriers to screening and practice behaviours. RESULTS: All 65 invited physicians participated in the survey, including 46 (70.8%) family medicine physicians and 19 (29.2%) general internists. Most physicians knew that screening should begin at 50 years of age, all knew to screen men and women and 92% said they screened average-risk patients. Fifty-seven (87.7%) physicians correctly identified three common characteristics associated with high risk for developing CRC. Physicians who screened average-risk patients preferred fecal occult blood testing (88.3%) and colonoscopy (88.3%) to flexible sigmoidoscopy (10.0%) and double-contrast barium enema (30.0%). Most physicians knew the correct screening periodicity for fecal occult blood testing (87.6%), but only 40% or fewer could identify correct screening periodicities for the other modalities. Barriers and facilitators focused on health care delivery system improvements, better evidence on which to base recommendations and development of practical screening modalities. CONCLUSIONS: Physicians lacked knowledge of the recommended screening modalities and periodicities to appropriately screen average-risk individuals. Because CRC screening can reduce mortality, efforts to improve physician delivery should focus on physician knowledge and changes to the health care delivery system.
Authors: Elizabeth A McGlynn; Steven M Asch; John Adams; Joan Keesey; Jennifer Hicks; Alison DeCristofaro; Eve A Kerr Journal: N Engl J Med Date: 2003-06-26 Impact factor: 91.245
Authors: Adam F Barrison; Christopher Smith; Jaime Oviedo; Timothy Heeren; Paul C Schroy Journal: Am J Gastroenterol Date: 2003-06 Impact factor: 10.864
Authors: Maida J Sewitch; Mengzhu Jiang; Roland Grad; Mark Yaffe; Alan Pavilanis; Lawrence Joseph; Alan N Barkun; Mark Roper Journal: Can Fam Physician Date: 2013-12 Impact factor: 3.275
Authors: Tiffany Brown; Ji Young Lee; Jessica Park; Christine A Nelson; Mary Ann McBurnie; David T Liss; Erin O Kaleba; Eric Henley; Padmini Harigopal; Laura Grant; Phil Crawford; Joseph E Carroll; Kari Alperovitz-Bichell; David W Baker Journal: Prev Med Rep Date: 2015-09-21