Colorectal cancer screening and surveillance practices by primary care physicians: results of a national survey

Abstract

Colorectal cancer screening practices by primary care physicians vary considerably from those recommended. Many offer screening to individuals in whom it is not appropriate, and continue it into advanced age. Frequent, inappropriate use of fecal occult blood tests will produce many false positives. Primary care physicians often do not appropriately follow a positive test. Further educational efforts are needed in an attempt to improve practice and further reduce the morbidity and mortality from colorectal cancer.

Measuring the Quality of Colorectal Cancer Screening: The Importance of Follow-Up

“…6,8,18 The quality of follow-up also has been questioned, because many physicians seem reluctant to initiate a complete colon examination (barium enema or colonoscopy) after a positive FOBT. 7,19,20 McGlynn et al 21 recently found that 59 percent of patients in the United States received follow-up care considered appropriate by an expert panel. The extent to which these problems occur surely varies widely between organizations and providers.…”

The Role of GPs in Increasing Compliance to Colorectal Cancer Screening: A Randomised Controlled Trial (Italy)

“…Even though GPs are considered very important in any preventive practice because of their natural proximity to healthy beneficiaries, several studies have shown that GPs are not always well informed about CRCS practice, a consistent percentage of them do not trust FOBTs as an effective screening tests and finally there is a large variability in the recommendations given to their beneficiaries about CRCS [7][8][9][10][11][12][13][14].…”

Colonoscopy is the preferred colorectal cancer screening method in a population-based program

“…Colonoscopy was the screening method preferred by the major− ity of those willing to undergo screening. This was unexpected because many primary care physicians tend to recommend FOBT and flexible sigmoidoscopy rather than colonoscopy, de− spite the fact that over 80 % of them perceive colonoscopy to be a very efficacious screening procedure for CRC [19,20]. This con− trast may be explained by the findings of Ling and colleagues [26], who found that, whereas 54 % of patients considered accu− racy to be the most important feature in selecting a screening method, this figure was only 15 % in the physicians' perception of the patients' evaluation.…”