On attitudes about colorectal cancer screening among gastrointestinal specialists and general practitioners in the Netherlands

Colorectal cancer screening behaviors of general surgeons and first-degree family members: a survey-based study

BACKGROUND

Colorectal cancer (CRC) screening rates are low in the general population and among health care providers. The aim of this study was to evaluate the CRC screening practices of general surgeons who provide specialized diagnostic testing and CRC treatment and to examine the CRC screening behaviors of their first-degree family members.

METHODS

A cross-sectional survey was conducted among general surgeons who attended the 21st National Surgical Congress in Turkey held from April 11th to 15th, 2018. The survey included items on demographics, screening-related attitude, CRC screening options, barriers to CRC screening, and surgeons' annual volumes of CRC cases.

RESULTS

A total of 530 respondents completed the survey. Almost one-third of the responding surgeons (29.4%, n = 156) were aged over 50 years, among whom approximately half (47.1%, n = 74) reported having undergone CRC screening and preferring a colonoscopy as the screening modality (78.4%). Among general surgeons aged 50 years and older, high-volume surgeons (≥25 CRC cases per year) were more likely to undergo screening compared with low-volume surgeons (< 25 CRC cases per year). The respondents aged below 50 years reported that 56.1% (n = 210) of their first-degree relatives were up-to-date with CRC screening, mostly with colonoscopy. Compared to low-volume surgeons aged below 50 years, high-volume surgeons' first-degree relatives were more likely to be up-to-date with CRC screening.

CONCLUSION

The survey results demonstrated that routine screening for CRC among surgeons and/or their first-degree relatives is currently not performed at the desired level. However, high-volume surgeons are more likely to participate in routine screening.

Awareness and attitudes of Greek medical students on colorectal cancer screening

AIM: To prospectively assess the knowledge and attitudes of medical students (MS), as tomorrow’s physicians, about colorectal cancer (CRC) and its screening modalities.

METHODS: Three hundred fourth year MS of the University of Athens were enrolled in this survey. Their selection was random, based on student identification card number. All participants completed an anonymous written questionnaire over a 4 month period. The questionnaire was divided into 4 sections and included queries about CRC-related symptoms, screening with colonoscopy and MS awareness and attitudes in this field. Following collection and analysis of the data, the results are presented as percentages of answers for each separate question.

RESULTS: Two hundred and sixty-five students answered the questionnaire over a 4 mo period. Interestingly, only 69% of the study population considered CRC to be a high-risk condition for public health. However, the vast majority of participants identified CRC-related symptoms and acknowledged its screening to be of great value in reducing CRC incidence and mortality. A very small proportion (38%) had received information material regarding CRC screening (either during their medical training or as a part of information provided to the general public) and only 60% of the participants declared willingness to receive further information. Regarding colonoscopy, 85% would prefer an alternative to colonoscopy methods for CRC screening. Moreover, 53% considered it to be a painful method and 68% would appreciate more information about the examination.

CONCLUSION: MS in Greece need to be better informed about CRC screening and screening colonoscopy.

The use of registered nurses to perform flexible sigmoidoscopy procedures in ontario: a cost minimization analysis

RATIONALE

Rates of colorectal cancer (CRC) are on the rise in Canada. Flexible sigmoidoscopy (FS) is an initial screening test for CRC primarily used in adults aged 50 years and older at average risk for the disease. Physicians and registered nurses have been shown to have the same effectiveness in performing a FS procedure. This paper presents an analysis of the use of registered nurses (RN) compared to physicians in Ontario to assess costs to the healthcare system.

OBJECTIVES

To evaluate whether FS performed by RNs is a less costly alternative to increase access to CRC screening capacity in Ontario.

METHODOLOGY

A cost minimization analysis was conducted from a health system perspective.

DISCUSSION

RN-performed FS is a viable alternative for increasing CRC screening capacity in Ontario. Remuneration schedules for on-call physicians must be taken into consideration if policies are developed for the implementation of RN screening procedures.

RESULTS

The findings suggest that the use of RNs may be cost saving compared to physician-performed FS procedures, depending on physician remuneration.

Colorectal cancer screening perceptions and practices: results from a national survey of gastroenterology, surgery and radiology trainees

BACKGROUND

Colorectal cancer (CRC) screening in the United States is suboptimal. We conducted a national survey to learn about CRC screening perceptions and practices among trainees who perform CRC screening tests including those enrolled in Gastroenterology and Hepatology (GIH), General and Colorectal Surgery, and Diagnostic and Abdominal Radiology training programs.

METHODS

Program directors/administrators (PDs/PAs) from 642 programs were contacted by e-mail with an invitation to forward our survey to trainees in their programs. Participating trainees then completed an anonymous, Web-based questionnaire.

RESULTS

A total of 130/642 (20%) PDs/PAs forwarded our survey to their trainees, with responses received from 476 trainees (80 GIH, 261 surgery, 135 radiology). Colonoscopy was felt to be the best CRC screening test at reducing CRC mortality, with patient-related factors perceived as greater barriers than system-related factors. No single guideline was deemed very influential on CRC screening practices by most trainees. A total of 2 of 5 above-average risk patient profiles were not recognized by most trainees. Colonoscopy was selected as the preferred follow-up test for a positive CRC screening test by most trainees. However, 34% of respondents chose an option other than colonoscopy alone for follow-up of a positive fecal occult blood test.

CONCLUSIONS

Based on data from this national survey of gastroenterology, surgery, and radiology trainees, opportunities exist for curricular changes that may help enhance current perceptions and practices of trainees who perform CRC screening tests.