Colorectal cancer screening: practices and opinions of primary care physicians.
BACKGROUND
The Canadian Task Force on Preventive Health Care (CTFPHC), in 2001, concluded that there is good evidence to include annual or biennial fecal occult blood testing (FOBT) and fair evidence to include flexible sigmoidoscopy in the periodic health examination of asymptomatic adults more than 50 years of age.


METHODS
Mailed survey of Alberta primary care physicians to determine current colorectal cancer (CRC) screening practices, familiarity with the new guideline, and opinions about, and barriers to, screening average-risk patients.


RESULTS
Response rate was 58.0% (n = 965). Less than half (41.9%) were familiar with the new Canadian guideline. The majority (74.7%) recommended that asymptomatic patients undergo screening; however, only 35.6% offered screening to at least 75% of average-risk patients. Few (9.4%) rated fecal occult blood as an "excellent or very good" screening test. Most (64.1%) physicians would choose colonoscopy if they themselves were to undergo screening. Concerns were raised about cost-effectiveness, inconsistencies of current recommendations, and resources.


CONCLUSIONS
Although supportive of colorectal cancer screening of average-risk patients, few physicians recommend screening for the majority of their patients. Clarification of inconsistencies between guidelines, resource issues, and the availability of efficacious screening tests is required for wider acceptance of the new Canadian guideline.
McGregor
S Elizabeth
SE
Division of Population Health and Information, Alberta Cancer Board, Calgary, Alberta, Canada T2N 4N2. elizabeth.mcgregor@cancerboard.ab.ca
Hilsden
Robert J
RJ
Murray
Alison
A
Bryant
Heather E
HE
D000328:Adult; D000368:Aged; D002170:Canada; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D010820:Physicians / Q000523:psychology; D010818:Practice Patterns, Physicians' / Q000592:standards; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D011795:Surveys and Questionnaires