The view from two sides: a qualitative study of community and medical perspectives on screening for colorectal cancer using FOBT.
BACKGROUND
Population-wide screening for people at average risk of colorectal cancer (CRC) by faecal occult blood test (FOBT) is under consideration in Australia.


METHODS
Qualitative methods were used to examine the views of community members who did (n = 18) or did not (n = 12) participate in a pilot program of FOBT screening. In addition, views were obtained from general practitioners (GPs) and specialist gastroenterologists directly involved in the implementation of the program. Two focus group sessions were conducted with screening participants and interviews were conducted with nonparticipants, GPs and gastroenterologists.


RESULTS
The findings suggest that CRC screening by FOBT distributed to households by mail was well accepted by the community and by the medical practitioners involved in its implementation. The trial had little negative effect on general practice. Both medical practitioners and consumers raised concerns about the efficacy of FOBT screening. Medical practitioners were also concerned about the potential burden mass screening could place on the public (government-funded) health care sector.


CONCLUSIONS
It would seem that CRC screening using FOBT will not enjoy unqualified support from the community or from medical practitioners involved in the continuum of screening. Information about the objectives of screening programs, in general, and the efficacy of FOBT screening in particular, needs to be provided to the community to ensure informed individual choice.
School of Population Health, University of Queensland, Herston, QLD, Australia. a.clavarino@sph.uq.edu.au
Alexandra M
AM
Clavarino
Monika
M
Janda
Karen L
KL
Hughes
Christopher
C
Del Mar
Shilu
S
Tong
Warren R
WR
Stanton
Joanne F
JF
Aitken
Barbara A
BA
Leggett
Beth
B
Newman
D000368:Aged; D001291:Attitude of Health Personnel; D003113:Colonoscopy / Q000592:standards / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D003153:Community Health Services / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods; D008507:Medically Underserved Area; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D036301:Qualitative Research; D011793:Queensland / Q000453:epidemiology; D018570:Risk Assessment; D012959:Socioeconomic Factors