The role of GPs in increasing compliance to colorectal cancer screening: a randomised controlled trial (Italy).
OBJECTIVE
To assess the effect of the provider (GPs versus hospital) on the compliance in returning the faecal occult blood test. To analyse the characteristics of the GP associated with high compliance among his beneficiaries.


METHODS
A questionnaire about screening attitudes was mailed to the 1192 GPs working in 13 districts of the Lazio region. We asked the GPs to participate in a randomised trial, we sampled 130 GPs and about 1/10 of the GPs' 50-75 year old beneficiaries (n = 3657) were invited to be screened at the GP office and 1/10 (3675) at the nearest gastroenterology centre.


RESULTS
58.5% of the GPs completed the questionnaire and 22.7% agreed to participate in the trial. The compliance in the GP arm was 50%, in the hospital arm 16% (RR 3.4; 95% CI: 3.13-3.70). There was a high variability in the compliance obtained by the GPs. GPs with more than 25 patients visited/day and those incorrectly recommended screening of colorectal cancer obtained a lower compliance (OR 0.74, 95% CI: 0.57-0.95 and OR 0.76, 95% CI: 0.59-0.97, respectively).


CONCLUSIONS
The involvement of GPs in colorectal cancer screening can be very effective to enhance the compliance, but the effectiveness is dependent on their willingness to be involved.
Federici
Antonio
A
Agency for Public Health, Lazio Region, via di S. Costanza 53, 00198, Rome, Italy.
Giorgi Rossi
Paolo
P
Bartolozzi
Francesco
F
Farchi
Sara
S
Borgia
Piero
P
Guastcchi
Gabriella
G
D000368:Aged; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance; D010819:Physician's Role; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires