Knowledge and practice of physicians regarding colorectal cancer screening

Abstract

Introduction: Despite the high prevalence and high rates of mortality of colorectal cancer, it is likely to be a secondary prevention disease due to the presentation of characteristics that are ideal for a successful screening program, with a proven positive impact on its outcome. Objective: To describe the knowledge and practice of physicians concerning screening tests for the prevention of colorectal cancer. Methods: Cross-sectional study carried out between November 2011 and February 2012, through a questionnaire administered to 83 physicians who assist adult patients at the University Hospital of Universidade Luterana do Brasil and at basic health units of Canoas, Rio Grande do Sul, Brazil. Results: From the number of physicians participating in the survey, only 35 (42.0%) reported prescribing tests for colorectal cancer screening. Out of these, only 21 used the screening on patients aged 50 years old or more, as recommended by the guidelines. Only 65.0% of the physicians reported investigating family history of colorectal cancer, and surgical experts were the ones who least investigated this risk factor (p=0.005), when compared with clinical and gynecology specialties. Conclusions: The number of physicians who reported ordering tests for the prevention of colorectal cancer is still low, and their knowledge regarding the recommendations of the guidelines is very limited. The results indicate the immediate need for investment in professional formation and medical staff training concerning preventive measures for colorectal cancer.

Providers' knowledge, attitudes, and practices related to colorectal cancer control in Brazil

“…Based on our survey results, we were not able to explain the lower screening practice among female physicians, and that should be further investigated. Supporting our finding that lack of CRC screening increases with number of years since graduation, a study done in Southern Brazil revealed that physicians who graduated more than 15 years ago were less aware of CRC screening recommendations than the ones who graduated more recently (Souza et al, 2012). This is possibly due to the relatively recent introduction in Brazil of INCA recommendations for CRC screening in 2002.…”

“…Differences in knowledge, attitudes, and practice of CRC screening may exist among physicians and nurses practicing in public versus private sector. Souza et al did not find differences between physicians’ source of income (public, private, or both) and their knowledge and practice of CRC screening; however, the study had a small sample size and was based in one hospital (Souza et al, 2012). National provider-based studies analyzing possible differences between sectors are needed in order to understand the full picture of CRC screening in the Brazilian health system.…”

Análise do conhecimento sobre diagnóstico e prevenção do câncer colorretal em pacientes do Sistema Único de Saúde e alunos da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

“…Essa deficiência de educação específica para a prevenção das neoplasias malignas pode ter repercussão na prática clínica. De fato, em outro estudo sobre a atitude dos médicos oncologistas em relação à prevenção de diversas neoplasias malignas, foi observado que, em relação ao CCR, nenhum médico indicou exames de rastreamento de acordo com os consensos da Sociedade Americana de Cancerologia, Força-Tarefa Canadense ou do Instituto Nacional de Câncer (Tucunduva et al, 2004 (Souza et al, 2012).…”

“…Esses achados representam uma perda de oportunidade e podem contribuir para o aumento do impacto da doença no município. Em outro estudo, 80% dos médicos entrevistados responderam ter conhecimento sobre o rastreamento do CCR, no entanto, apenas 42,2% havia indicado algum dos métodos para seus pacientes (Souza et al, 2012). Ainda nesse estudo, observouse que médicos com maior tempo de formação foram os que apresentaram maior desconhecimento a respeito da prevenção do CCR.…”