title: Colorectal cancer screening: recommendations and guideline adherence by physicians from digestive endoscopy centers in the Lazio region, Italy.
abstract: BACKGROUND
  Endoscopy plays a key role in colorectal cancer screening; at the beginning of a mass screening campaign, it is important for public health officials to assess physicians' attitudes and adherence to guidelines regarding colorectal cancer screening.
  
  
  METHODS
  In April 2004, a questionnaire was sent to all 80 digestive endoscopy centers in the Lazio region, identified by the annual census of the Italian Society of Digestive Endoscopy. The results were compared to those from a similar survey of general practitioners (GPs).
  
  
  RESULTS
  Seventy-one centers (89%) returned the questionnaire. Only 3% of physicians said they did not recommend any colorectal cancer screening test. Colonoscopy was perceived as the most effective screening test and was the most recommended (80%). Fecal occult blood test was recommended by 61% of physicians and flexosigmoidoscopy by 11%. Endoscopy centers' physicians recommend screening more than GPs (96.9% vs. 78.3%), while they have a similar level of over-recommending (50.8% vs. 47.2%). Almost 95% of endoscopy physicians properly recommended colonoscopy after positive FOBT.
  
  
  CONCLUSIONS
  Neither physicians at endoscopy centers nor GPs tend to follow screening guidelines. Screening programmes should not rely on a single medical specialist, but on interdisciplinary management of the disease to strengthen adherence to existing guidelines.
authors.affiliation: Agency for Public Health, Lazio Region, via di S. Costanza 53, 00198 Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Federici
authors.forename: Sabrina
authors.initials: S
authors.lastname: Valle
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.forename: Antonio
authors.initials: A
authors.lastname: Grassi
authors.forename: Piero
authors.initials: P
authors.lastname: Borgia
authors.forename: Gabriella
authors.initials: G
authors.lastname: Guasticchi
mesh_terms: D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D004724:Endoscopy; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires