Colorectal Cancer Screening: Knowledge and Practice among Private General Practitioners in Northeast Peninsular Malaysia

Abstract

Colorectal cancer screening is an important screening to detect colorectal cancer. Thus, the aim of this study is to determine the knowledge, practice and its associated factors of colorectal cancer screening among private general practitioners (PGPs) in Northeast Peninsular Malaysia. Crosssectional study was conducted involving 127 PGPs in Kelantan. The study used a validated selfadministrated questionnaire that contained three domains. The domains were sociodemographic, knowledge and practice of colorectal cancer screening. The inclusion criterion was doctors working in a private clinic for more than six months, while the exclusion criteria were non-residential doctors and doctors practicing in private specialised clinics. Only 21.3% of PGPs had good knowledge and 3.9% had good practice on colorectal cancer screening. The duration of practice as a PGP was significantly associated with good practice for colorectal cancer screening. Only 58.3% were aware of the current recommendation on colorectal cancer screening. Most PGPs would refer patients for a colonoscopy, but screening with faecal occult blood test (FOBT) in average-risk patients was low. Only 4% of PGPs followed the recommended guidelines for colorectal cancer screening. The main reasons for not offering FOBT screening were patients’ refusal, patients were not regular patients of the doctor and the referral system for colonoscopy was found to be difficult. This study noted that knowledge and practice of colorectal cancer screening among PGPs were inadequate. Overcoming barriers for screening is important to promote colorectal cancer screening.

Knowledge, attitude, practice, and perceived barriers of colorectal cancer screening among primary care physicians in the Kingdom of Bahrain

“…Furthermore, our study results showed a better knowledge about CRC screening among primary care physicians compared to a study done in Saudi Arabia that showed only about 34% of their primary care physicians had good knowledge about CRC screening and around 21% of primary care physicians had good knowledge about CRC screening in a similar study done in Malaysia. 19,21 In this study, most primary care physicians (63.2%) were able to identify the appropriate age of initiating CRC screening and 69% correctly answered that fecal occult blood testing should be repeated annually as a screening method for CRC screening. However only 49.4% correctly answered that colonoscopy should be repeated every 10 years for CRC screening.…”

“…The result of this study is consistent with other studies that relieved low level of practice among primary care physicians. 19,24,26 Most of the participants (89.7%) in this study reported lack of time as one of the barriers that hinder them from screening their patients for CRC. The regular consultation visit time is eight minutes, hence physicians might not get adequate time to explain to patients about performing FOBT to screen for CRC.…”

“…Other barriers that were mostly reported in this study and in the literature as well are patients in hurry, poor patients' awareness and patients' refusal to do the screening test. 13,19,22,27,28 Poor public awareness of the burden of CRC and the importance of early detection in the prognosis of the disease could be a major factor for those barriers of not performing CRC screening. In addition, poor physicians' and nurses' knowledge about CRC may also contribute to the unawareness of patients about CRC as doctors and nurses are an important source of medical information to the public.…”

“…14 Many studies all over the globe have explored the knowledge, attitude and practice of primary care physicians towards CRC screening in order to improve the practice of early detection and hence better prognosis of colorectal cancer cases. [15][16][17][18][19][20] In the Kingdom of Saudi Arabia, studies have shown that primary care physicians have good level of knowledge regarding CRC screening and the recommendations, however their practice towards screening was suboptimal 17,18 . On the other hand, studies conducted in Malaysia, Oman and Canada shows that physicians have poor knowledge regarding CRC screening 15,19,20 .…”

“…[15][16][17][18][19][20] In the Kingdom of Saudi Arabia, studies have shown that primary care physicians have good level of knowledge regarding CRC screening and the recommendations, however their practice towards screening was suboptimal 17,18 . On the other hand, studies conducted in Malaysia, Oman and Canada shows that physicians have poor knowledge regarding CRC screening 15,19,20 . In Bahrain, no published literature was found to date that test the knowledge of the primary care physicians towards CRC screening and their practice.…”