Frédérique Papin-Lefebvre1, Elodie Guillaume2, Grégoire Moutel3, Guy Launoy2, Célia Berchi4. 1. Caen University Hospital (CHU), Forensic Institute, Côte de Nacre Hospital, Caen, F-14000, France; INSERM, U1086 "Cancers and Prevention", Normandie University, Centre François Baclesse, Caen, F-14076, France; Paris Descartes University, EA4569, Medical Ethics and Forensic Medicine Laboratory, Faculty of Medicine, Paris V, F-75005, France. 2. INSERM, U1086 "Cancers and Prevention", Normandie University, Centre François Baclesse, Caen, F-14076, France. 3. Paris Descartes University, EA4569, Medical Ethics and Forensic Medicine Laboratory, Faculty of Medicine, Paris V, F-75005, France. 4. INSERM, U1086 "Cancers and Prevention", Normandie University, Centre François Baclesse, Caen, F-14076, France. Electronic address: celia.berchi@unicaen.fr.
Abstract
OBJECTIVE: French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk METHODS: A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models. RESULTS: The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician. CONCLUSIONS: Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme.
OBJECTIVE: French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk METHODS: A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models. RESULTS: The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician. CONCLUSIONS: Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme.