Volume 185 - Issue 4
Attitudes of Western Australian general practitioners to colorectal cancer screening
Authors: Graham B Turner, Marcus W Chin, Noellene M Foster, Jon Emery and Geoff M Forbes
Med J Aust 2006; 185 (4): 237. || doi: 10.5694/j.1326-5377.2006.tb00542.x
Published online: 21 August 2006
Published online: 21 August 2006
To the Editor: A nationwide colorectal cancer (CRC) screening program will commence in 2006. It has been shown that general practitioners can influence their patients in the decision to have CRC screening.1,2 There are several screening test options in Australia, and the relative geographical isolation of rural centres may influence attitudes and participation.
We sought to determine the attitudes of GPs towards CRC screening and test preferences. Between January and September 2005, all GPs in Western Australia (n = 1837; 1298 metropolitan, 539 rural) were sent a questionnaire, which was completed by 801 (43.6%). Overall, 62.8% of respondents believed that asymptomatic average-risk subjects should have CRC screening (67.1% of metropolitan GPs v 54.2% of rural GPs; P = 0.003).
The questionnaire revealed major differences between which test GPs would recommend for their patients and which test they preferred for their own personal screening (Box). These differences were related to the factors GPs believed were most likely to influence choice of screening test. For colonoscopy, accuracy and speed of result were considered most important; for faecal occult blood testing, no need for bowel preparation or time off work and no discomfort were considered the strongest determinants. Previous studies that included patients’ views have found that physicians may incorrectly perceive certain factors in screening to be important to their patients.3 There were no significant differences in choice of test between rural and metropolitan GPs.
Although the target age group for the Australian pilot study and the national screening program is 55–74 years,4,5 two thirds of GP respondents felt screening should be offered from the age of 50 years, and a quarter believed it should continue beyond 80 years. Many GPs (65%) indicated they would like further education on CRC screening.
In summary, there is good support for CRC screening among Western Australian GPs, but the availability of different screening tests and variations in GPs’ opinions are likely to significantly influence clinical practice.
References
- Salkeld GP, Solomon MJ, Short L, Ward J. Measuring the importance of attributes that influence consumer attitudes to colorectal cancer screening. ANZ J Surg 2003; 73: 128-132. 0_CBBICDFB
- Thomas RJ, Clarke VA. Colorectal cancer: a survey of community beliefs and behaviours in Victoria. Med J Aust 1998; 169: 37-40. 0_i1091844
- Ling BS, Moskowitz MA, Wachs D, et al. Attitudes toward colorectal cancer screening tests. J Gen Intern Med 2001; 16: 822-830. 0_i1091847
- Australian Cancer Network Colorectal Cancer Guidelines Revision Committee. Clinical practice guidelines for the prevention, early detection and management of colorectal cancer (CRC). 2nd ed. Sydney: The Cancer Council Australia and Australian Cancer Network, 2005. http://www.cancer.org.au/content.cfm?randid=408243 (accessed Jun 2006).
- Australian Government Department of Health and Ageing. Australia’s bowel cancer screening pilot and beyond. Final evaluation report. Bowel Cancer Screening Pilot Monitoring and Evaluation Steering Committee, October 2005. Canberra: Commonwealth of Australia, 2005. http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/eval-oct05-cnt/$File/eval-oct05.pdf (accessed Aug 2006).
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