Four hundred and seventy-two consecutive referral episodes relating to 386 patients attending the Occupational Health Department of a general teaching hospital were analyzed to evaluate the frequency, content and effect on management of communications between the occupational physician and other doctors. In all, 250 episodes (53%) were associated with such a communication. The likelihood of a communication was strongly influenced by reason for referral, particularly in respect of long or short term sickness absence; univariate odds ratios (OR) = 10.58, 95% CI = 8.13-27.08) and 2.65, 95% CI = 1.55-4.60) respectively; a medical diagnosis of psychiatric illness (OR = 3.17, 95% CI = 1.69-5.97)); and by number of consultations. Communication was also more likely when the occupational outcome was ill health retirement, rehabilitation in work or modified work. Ninety-eight per cent of specific requests for information or an opinion elicited a reply. Information received from other doctors influenced the occupational health physician's management in 52 referral episodes (20%). Specific action by GPs as a result of communication was documented in 54 and by specialists in 37 episodes. The importance of communication between occupational health physician and other doctors in the occupational health process is confirmed.
This study showed a higher return to work rate in the first year, following treatment for breast cancer, than described previously. Workplace adjustments, recommended by an occupational physician, were provided for the majority.
Study objective-The assessment of the uptake of colorectal cancer screening oVered in a workplace setting.
Design-Employees were oVered a free faecal occult blood test (Haemoccult
>5.5, p<0.02).Remailing raised compliance slightly from 43.6% to 46.3%. Four employees (1%) had positive faecal occult blood tests but three were negative on repeat testing with dietary restrictions. Conclusions-The government favours the development of health promotion programmes as stated in its document "Health at work in the NHS". The response in this study, showed methods to increase compliance must be developed if such programmes are to be successful. As uptake was similar to that in several community based programmes in general practice, workplace based programmes could oVer a complementary method of delivering screening. (J Epidemiol Community Health 1998;52:818-820) Colorectal cancer is the second commonest malignancy in Britain with over 20 000 fatalities each year.
Summary
Changes in the pattern of presentation of carcinoma of the uterine cervix between 1960 and 1975 were studied using the records of 3193 patients registered with the East Anglian Cancer Registration Bureau. Between 1963 and 1968, an increased registration rate for invasive tumours was largely attributable to increased registrations of Stage I and I1 lesions in the 35 to 49 age group. After 1970 the registration rate for lesions of all stages in this age group declined. Over the same period the 50 to 64 age group showed a tendency for an increased proportion of registrations to be of Stage I or I1 lesions. There was little change in pattern in the over‐65 age group. The possible relation of these changes to the introduction of a cervical cytology screening programme and the implications for future screening policies are discussed.
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