title: Responsibilities in cancer preventive care in Greece. A physicians' survey.
abstract: BACKGROUND
  Colorectal cancer is the second leading cause of cancer death in European countries. Differences in screening implementation may explain USA vs. European survival differences. The proportion of European primary care physicians advising colorectal screening has been reported to be inconsistent. We therefore hypothesised the presence of a belief-related bias among European physicians regarding who is responsible for cancer screening delivery.
  
  
  OBJECTIVE
  To index beliefs in cancer screening implementation among a wide sample of Greek physicians. Study design Cross-sectional survey.
  
  
  METHODS
  Three hundred and sixty-six physicians involved in primary care activities in 15 provinces answered a questionnaire about responsibility in cancer screening delivery. Results 22.4% and 7.6% of physicians declared that the health system and the patients, respectively, have the main responsibility for cancer screening implementation, while 70 % advocated patient-health system co-responsibility. Beliefs were statistically correlated to age (p=0.039) and specialisation category (p=0.002). Patients' will was mainly indicated by internists, trainee internists and physicians older than 30, while GPs, trainee GPs and house officers were mainly health system-oriented. Worryingly, when physicians were asked about which specialty should inform the population, 81% indicated family doctor (for-fee-service) while the involvement of free-from-fee specialities was inconsistent.
  
  
  CONCLUSIONS
  A considerable disorientation about responsibilities in cancer screening delivery was observed in our study sample. Continual medical education and clear redefinition of primary care physicians' activities are required.
authors.affiliation: PACMeR (Panhellenic Association for Continual Medical Research), Section of Public Health, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Zacharias
authors.forename: Apostolos
authors.initials: A
authors.lastname: Xilomenos
authors.forename: Georgios
authors.initials: G
authors.lastname: Koukourakis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kamposioras
authors.forename: Davide
authors.initials: D
authors.lastname: Mauri
authors.forename: Dimitra
authors.initials: D
authors.lastname: Chasioti
authors.forename: Magdalini
authors.initials: M
authors.lastname: Bristianou
authors.forename: Georgios
authors.initials: G
authors.lastname: Ferentinos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Levantakis
authors.forename: Lamprini
authors.initials: L
authors.lastname: Tsali
authors.forename: Antonis
authors.initials: A
authors.lastname: Valachis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Karampoiki
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D003625:Data Collection; D005260:Female; D006115:Greece; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'