Dataset Information

Frequency of colorectal cancer screening and the impact of family physicians on screening behaviour.

ABSTRACT:

Background

Mortality associated with colorectal cancer can be reduced by early detection. However, the participation of eligible people in colorectal cancer screening is thought to be inadequate. We examined the frequency of colorectal cancer screening in 4 Canadian provinces and the influence of patient contact with a family physician on the uptake of cancer screening.

Methods

We performed analyses using data from the 2003 Canadian Community Health Survey. The study population included 12,776 people at average risk for colon cancer living in British Columbia, Saskatchewan, Ontario, and Newfoundland and Labrador who were aged 50 years or older and who were eligible for colorectal cancer screening. We assessed the proportion of respondents who reported having previous colorectal cancer screening tests and the degree of contact with a family physician.

Results

The provincial response rates for the survey were 78.5%-87.0%. The proportion of respondents who reported any history of colorectal cancer screening was 23.5%. This value dropped to 17.6% when only up-to-date screening was considered (screening within the time frame recommended in guidelines). The proportion of people with up-to-date colorectal cancer screening varied significantly among provinces, but it was low in all provinces sampled. Contact with a family physician was associated with increased colorectal cancer screening. Compared with no physician contact, the odds of screening associated with 1-2 physician contacts in the 12 months before the survey was 1.97 (95% confidence interval [CI] 1.56-2.48], and the odds of screening associated with more than 4 contacts was 2.75 (95% CI 2.14-3.53).

Interpretation

Self-reported colorectal cancer screening falls well below acceptable levels. People with increased contact with a family physician are more likely than those without contact to report a history of up-to-date colorectal cancer screening.

SUBMITTER: Zarychanski R

PROVIDER: S-EPMC1963385 | biostudies-literature | 2007 Sep

REPOSITORIES: biostudies-literature

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Publications

Frequency of colorectal cancer screening and the impact of family physicians on screening behaviour.

Zarychanski Ryan R Chen Yue Y Bernstein Charles N CN Hébert Paul C PC

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20070901 6

<h4>Background</h4>Mortality associated with colorectal cancer can be reduced by early detection. However, the participation of eligible people in colorectal cancer screening is thought to be inadequate. We examined the frequency of colorectal cancer screening in 4 Canadian provinces and the influence of patient contact with a family physician on the uptake of cancer screening.<h4>Methods</h4>We performed analyses using data from the 2003 Canadian Community Health Survey. The study population in ...[more]

PMID: 17846441

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Project description:BackgroundThe organized colorectal cancer (CRC) screening program in the canton of Vaud, Switzerland offers citizens the choice of the faecal immunochemical test (FIT) or colonoscopy via a visit with a family physician (FP). Given the central role of FPs in the program, this study aimed to compare their self-reported preventive practices with the objectives of the program, namely to inform patients about CRC screening and present the choice of colonoscopy and FIT, and to identify factors associated with presenting a choice of tests.MethodsMixed-methods study using an online survey and semi-structured interviews. Participants were FPs from the canton of Vaud who had included ?1 patient in the screening program. We used multivariate logistic regression to compare FPs offering only colonoscopy to those who offered a choice of tests or FIT.ResultsThe participation rate was 40% (177 respondents / 443 eligible). Most FPs (68%) reported informing more than 75% of eligible patients about the program. Lack of time (n?=?86, 33%) was the principal reason cited for not informing patients. Regarding the screening methods, 20% (n?=?36) of FPs prescribed only colonoscopy, 13% (n?=?23) only FIT and 65% (n?=?115) both screening methods. Predictors of offering only colonoscopy rather than a choice of screening tests included: first, FP reporting that they chose/would choose colonoscopy for themselves (OR 8.54 [95% CI 1.83-39.79, P?<?0.01]); second, being >?20?years in practice (OR 4.8 [95% CI 1.3-0.17.66, P?=?0.02]); and third, seeing 300 or more patients per month (OR 3.05 [95% CI 1.23-7.57, P?=?0.02]). When asked what could improve the program, 17% (n?=?31) wrote that patients should be informed in advance about the program by postal mail and a large-scale communication campaign.ConclusionThe majority of FPs reported CRC screening practices consistent with the objectives of the program. However, to ensure that patients are well informed and to save time, all patients need to be systematically informed about the program. Further, FPs should be encouraged to offer a choice of tests.

Project description:BACKGROUND/AIM:Early diagnosis of chronic illnesses and cancers mainly occurs at primary health care centers (PHCs) by primary health care physicians (PHPs). The incidence of colorectal cancer (CRC) in the Kingdom of Saudi Arabia (KSA) is rising and this has been attributed to many factors. The increasing incidence of CRC is compounded by nonadherence to screening recommendations. Therefore, evaluating PHPs knowledge, attitudes, and practices of screening for CRC is clinically important. We aimed to evaluate the knowledge, attitudes, and practices of PHPs regarding CRC screening and to identify the factors associated with nonadherence of PHPs to screening recommendations. MATERIALS AND METHODS:PHPs working at three tertiary care centers and PHCs across the city of Jeddah were randomly recruited. Participants were surveyed using a comprehensive questionnaire that recorded data on demographics, qualifications, and knowledge of various modalities and guidelines related to CRC screening. Perspectives about effectiveness of, or adherence to, factors that influence physicians' perspectives or recommendations for CRC screening were also assessed. Logistic regression analysis was used to identify physician characteristics associated with PHPs perspectives and nonadherence to CRC screening. RESULTS:A total of 127 PHPs were recruited. The average age of participants was 34 (±8.4) years, 86.6% were native Saudi's and 56.7% were females. The majority of surveys (66.9%) were completed at 24 PHCs and the remaining at hospital-based family medicine clinics. Most of the PHPs (55%) had a bachelor's degree and 31.5% were board-certified or carried a PhD in family medicine; 95% of participants believed that CRC screening in general was effective, but as much as 55% reported that they did not practice screening. The male physicians [odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.19-0.99, P = 0.048)] and PHPs with only a bachelor degree or less (OR = 0.72, 95% CI = 0.55-0.93, P = 0.011) were less likely to recommend screening for CRC. CONCLUSIONS:A considerable proportion of PHPs do not adhere to CRC screening recommendations despite a wide belief that screening is effective. Male PHPs with lower qualifications appear to be less likely to recommend screening.

Dataset Information

Frequency of colorectal cancer screening and the impact of family physicians on screening behaviour.

Background

Methods

Results

Interpretation

Publications

Frequency of colorectal cancer screening and the impact of family physicians on screening behaviour.

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