General practitioner and specialist views on colonoscopic screening of first-degree relatives of colorectal cancer patients.
BACKGROUND
Barriers to targeted colonoscopic screening of first-degree relatives of colorectal cancer patients have been the subject of considerable literature, always as seen from the patient's viewpoint. In the specific context of screening individuals with a family history, physicians may also play a predominant role in motivating their colorectal cancer patients to pass on screening information to their relatives. The aim of this study was to examine the views of general practitioners and specialists regarding barriers and facilitators affecting participation of relatives in colonoscopic screening.


METHODS
A qualitative study was conducted to collect and analyse information from two focus groups of 4 general practitioners and 9 gastroenterologists respectively, and from semi-structured individual interviews with 10 general practitioners, 2 surgeons and 3 oncologists. An extended focus group of 36 gastroenterologists was organized to validate the results.


RESULTS
The main barriers to colonoscopic screening of FDRs were associated with lack of direct communication between physicians and FDRs. Physicians needed support in the task of informing index patients and persuading them to transfer information on screening to their FDRs. The general practitioners spoke of their expectations in terms of training in and motivation for promoting screening and the gastroenterologists expressed the wish for patient education material specific to colonoscopy and for systematic post-colonoscopy consultations to inform patients about their results, follow-up and screening their relatives.


CONCLUSIONS
The findings, notably the need for specific education materials and for training to improve the motivation of physicians, will help to develop effective interventions intended to increase participation in screening.
Ingrand
Isabelle
I
Epidemiology and Biostatistics, INSERM CIC-P 802, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France.
Dujoncquoy
Sarah
S
Beauchant
Michel
M
Letard
Jean-Christophe
JC
Migeot
Virginie
V
Ingrand
Pierre
P
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003625:Data Collection; D005260:Female; D017144:Focus Groups; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology; D012306:Risk; D013038:Specialization