Barriers to Colorectal Cancer Screening in Primary Care Settings: Attitudes and Knowledge of Nurses and Physicians

Abstract

Objective:Healthcare providers (HCPs) play a critical role in reducing colorectal cancer (CRC) related morbidity and mortality. This study aimed at exploring the attitudes and knowledge of nurses and physicians working in primary care settings regarding CRC screening.Methods:A total of 142 HCPs (57.7% nurses and 42.3% physicians) participated in a cross-sectional survey. Data were collected using a Self-administered Questionnaire. The participants were clinically experienced (mean = 9.39 years; standard deviation [SD] = 6.13), regularly taking care of adults eligible for CRC screening (62%) and had positive attitudes toward CRC screening (83.1%). Most participants (57%) had low levels of knowledge about CRC screening (mean = 3.23; SD = 1.50). The participants were most knowledgeable about the recommended age for initiating screening (62.7%) and the procedures not recommended for screening (90.8%).Results:More than 55% did not know the frequency of performing specific screening procedures, the upper age limit at which screening is not recommended, and the patients at high-risk for CRC. There were no significant differences between nurses’ and physicians’ attitudes and knowledge. The participants’ perceptions about professional training (odds ratio [OR] = 2.17, P = 0.003), colonoscopy (OR = 2.60, P = 0.014), and double-contrast barium enema (OR = 0.53, P = 0.041), were significantly associated with knowledge about CRC screening.Conclusions:The inadequate knowledge levels among nurses and physicians may be one of the barriers affecting CRC screening. Enhancing HCPs knowledge about CRC screening should be considered a primary intervention in the efforts to promote CRC screening and prevention.

Attitudes toward and Knowledge of Colorectal Cancer Screening among an Omani Adult Population Attending a Teaching Hospital

“…Lack of awareness concerning CRC screening has been linked to limited recommendations for CRC screening on the part of healthcare practitioners and medical recommendations from healthcare practitioners are a strong motivator and predictor for screening participation (Janz et al, 2003). Previous studies conducted in Oman and other Arab countries have noted that the majority of doctors and nurses do not encourage patients to take part in CRC screening as they themselves are not knowledgeable with regards to the recommended frequency of CRC screening or the importance of early CRC screening for high-risk patients (Galal et al, 2016;Muliira et al, 2016). In Palestine, only 14% of participants stated that their doctors had informed them of CRC screening measures (Qumseya et al, 2014).…”

“…In Oman and other Middle Eastern countries, local healthcare systems do not support continuity of care as patients are often seen by any doctor available whether they attend governmental or private health institutions (Mohammed Al-Azri et al, 2014;Saleh et al, 2015). Thus, improving knowledge of the importance of CRC screening and continuity of care among doctors and healthcare practitioners in Oman should be considered (Muliira et al, 2016). Unfortunately, many doctors practicing in local health centers in Oman lack the time to educate their patients regarding screening measures, especially if they themselves are unaware of official recommendations.…”

Understanding primary care nurses’ contribution to cancer early diagnosis: A systematic review

“…and Australia (n=1). The Omani study was published in two different articles (Muliira et al, 2016a;2016b), and one Brazilian study was published in three (Hallowell et al, 2017;Perin et al, 2015;Stormo et al, 2014).…”

“…14 studies met one criterion (Boone et al, 2016;Blake & Malone, 2014;De Moraes et al, 2016;De Souza Teixeira et al, 2017;Esteban-Vasallo et al, 2017;Lawvere et al, 2004;McIlfatrick et al, 2014;Muliira et al, 2016aMuliira et al, , 2016bOmran et al, 2015;Patel et al, 2016;Ramos et al, 2010;Shaheen et al, 2000;Shimpi et al, 2016;Yousuf et al, 2012), three met two (Cooper et al, 2014;Ertem, 2009;Meng et al, 2007), and one met three (Hallowell et al, 2017;Perin et al, 2015;Stormo et al, 2014). (Ertem, 2009;Yousuf et al, 2012).…”

“…In the US, 50.0% of nurses knew the correct age of initiation for cervical screening to be '21 years' (Boone et al, 2016); 72.0% knew the recommendation for breast screening to be '40 years' (Lawvere et al, 2005). In Oman, 62.2% of nurses correctly identified '50 years' to be the recommendation for colorectal screening (Muliira et al, 2016b).…”