Awareness of colorectal cancer screening in primary care physicians.
OBJECTIVE
Colorectal cancer is one of the leading causes of cancer related death worldwide. Primary care physicians play an important role in colorectal cancer screening. However the awareness and knowledge on the methods for colorectal cancer screening are still lacking. The authors aimed to assess Thai primary care physicians' knowledge and practice regarding colorectal cancer screening.


METHODS
Between October and December 2010, questionnaires were distributed to 447 Thai physicians. The questionnaires included demographic data, self-responded knowledge, and practice. Their responses were analyzed.


RESULTS
Three hundred eighty seven physicians completed the questionnaires (86.5% response rate). Of these, 44.7% were internists, 27.4% general practitioners (GPs), 11.9% surgeons, and 16.0% other specialists. Two hundred forty of physicians (62%) routinely recommended colorectal cancer screening to asymptomatic, average-risk patients. Only 43% gave the correct recommendation for the correct starting age. Colonoscopy (47.5%) and fecal occult blood test (40.0%) were preferred by the majority of physicians, whereas flexible sigmoidoscopy, double contrast barium enema, and CT colonoscopy were chosen by 5.7%, 4.4%, and 1.8% of physicians respectively. Surgeons had more knowledge of test efficacy and frequency. They also were more aware of colorectal cancer screening than internists. Patient ignorance (66.1%), unavailability of the test (64.6%), unawareness of physicians (57.9%), and financial problems (41.1%) were determinedas barriers for colorectal cancer screening.


CONCLUSIONS
Although the majority of physicians are aware of colorectal cancer screening, the correct knowledge is lacking. Colonoscopy and FOBT are their most preferred tests. Patient ignorance, unavailability of the test, unawareness of physician, and financial problems are the main barriers for colorectal cancer screening. Improvement in academic support services and standard clinical practice guideline are needed to improve overall morbidity and mortality of colorectal cancer.
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. tkessarin@hotmail.com
Kessarin
K
Thanapirom
Sombat
S
Treeprasertsuk
Rungsun
R
Rerknimitr
D000328:Adult; D002983:Clinical Competence; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D058007:Physicians, Primary Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013785:Thailand