1
|
Alzoubi MM, Al-Ghabeesh SH. Knowledge, Attitude, Practice, and Perceived Barriers Regarding Colorectal Cancer Screening Practices Among Healthcare Practitioners: A Systematic Review. Cureus 2024; 16:e54381. [PMID: 38505427 PMCID: PMC10948942 DOI: 10.7759/cureus.54381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/21/2024] Open
Abstract
The recommendations of medical professionals play a significant role in colorectal cancer (CRC) screening. This study aims to systematically review knowledge, attitude, practice, and perceived barriers regarding CRC screening practices among healthcare practitioners (HCPs). From January 2023 to December 2023, a comprehensive literature search was conducted using online databases, including Web of Science, PubMed, Scopus, and Research Gate, by using the following keywords in combination: "knowledge," "attitude," "practice," "perceived barriers," "colorectal cancer," and "health practitioners." The researchers screened and examined the retrieved literature. A total of 21 studies were considered relevant for the current review. Among these studies, eight assessed the level of knowledge, attitude, practices, and perceived barriers toward CRC screening among various health practitioners. Three studies assessed knowledge and attitudes toward CRC screening among health practitioners. The remaining ten studies assessed awareness, perceived barriers, or only knowledge of CRC screening among HCPs. In addition, all the included studies employed a cross-sectional design. The review shows that many healthcare providers need more fundamental knowledge of CRC screening. Healthcare procedures must be improved to enhance the knowledge, attitudes, and practices of healthcare professionals regarding CRC screening and their understanding of the associated barriers.
Collapse
|
2
|
Alghamdi AA, Almutairi AH, Aldosari FS, Al-Owayed AM, AlOtaibi HK, Alghamdi TA, Aldossary AS. Knowledge, Attitude, and Practice of Colorectal Cancer Screening Among Primary Healthcare Physicians in Riyadh Second Health Cluster. Cureus 2022; 14:e32069. [DOI: 10.7759/cureus.32069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/02/2022] Open
|
3
|
Mensah KB, Mensah ABB, Yamoah P, Attakorah J, Bangalee V, Oosthuizen F. Knowledge assessment and barriers to cancer screening among Ghanaian community pharmacists. J Oncol Pharm Pract 2021; 28:64-73. [PMID: 33430692 DOI: 10.1177/1078155220983413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Though there are controversies, cancer screening has been suggested to decrease mortality. Over the years, the most accessible primary healthcare provider; the community pharmacist, has developed an interest in being part of cancer screening activities and prevention of a wide range of other non-communicable diseases. To achieve this, community pharmacists need a working knowledge of the basic screening test and recommendations. Also, it's important to acknowledge the barriers that may prevent the implementation of cancer-screening efforts at the community pharmacy. This study aims to determine the knowledge and barriers to cancer screening among Ghanaian community pharmacists. METHODOLOGY Knowledge and barriers to cancer screening was assessed using an online questionnaire in 435 community pharmacists. Descriptive statistics and Pearson's chi-squared tests were used to analyze the data. RESULTS The reliability and validity assessment of the questionnaire after data collection revealed a Cronbach's alpha value of 0.82 for knowledge on cancer screening. The SD and mean age of study participants were 2.48 ± 20.08. Only 25.7% of the participants had good knowledge. The most identified barrier was the lack of established guidelines (60.9%). There was no association between participants' demographics and their knowledge scores. CONCLUSIONS Community pharmacists can potentially have a large impact on early detection of cancer through screening. However, they have to improve their knowledge on general screening guidelines and be aware of available educational resources to increase their knowledge. It is also important for all stakeholders to come together to establish local screening modalities and recommendations for the country.
Collapse
Affiliation(s)
- Kofi B Mensah
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Ghana.,College of Health Sciences, University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, Durban, South Africa
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Ghana
| | - Peter Yamoah
- School of Pharmacy, University of Health and Allied Sciences, Ghana
| | - Joseph Attakorah
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Ghana
| | - Varsha Bangalee
- College of Health Sciences, University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, Durban, South Africa
| | - Frasia Oosthuizen
- College of Health Sciences, University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, Durban, South Africa
| |
Collapse
|
4
|
Redwood DG, Blake ID, Provost EM, Kisiel JB, Sacco FD, Ahlquist DA. Alaska Native Patient and Provider Perspectives on the Multitarget Stool DNA Test Compared With Colonoscopy for Colorectal Cancer Screening. J Prim Care Community Health 2019; 10:2150132719884295. [PMID: 31646933 PMCID: PMC6820167 DOI: 10.1177/2150132719884295] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective: Alaska Native (AN) people have among the world's highest rate of colorectal cancer (CRC). We assessed perceptions of AN people and their health care providers of a new take-home multitarget stool DNA test (MT-sDNA; Cologuard) relative to colonoscopy. Methods: Cross-sectional surveys of AN people aged 40 to 75 years (mailed) and providers (online). Results: Participants included 1616 AN patients (19% response rate) and 87 providers (26% response rate; 57% AN people). Over half (58%) of patients preferred colonoscopy for CRC screening, while 36% preferred MT-sDNA. Unscreened patients were significantly more likely to state a preference for MT-sDNA than previously screened patients (42% vs 31%, P < .05) as were younger patients (<60 years old) compared with older patients (40% vs 30%, P < .05). Most providers thought that MT-sDNA would improve screening rates (69%), would recommend if available (79%), and be implementable (79%). Perceived barriers differed substantially between patients and providers in both type and magnitude. Leading colonoscopy barriers reported by patients were travel (44%) and bowel preparation (40%), while providers thought that fear of pain (92%) and invasiveness of the test (87%) were the primary barriers. For MT-sDNA, patients' belief that colonoscopy was better (56%) and not knowing how to do the test (40%) were primary barriers, while providers thought stool collection (67%) and having a stool sample in their home (63%) were leading barriers. Conclusions: This study found that MT-sDNA has potential acceptability among AN people and their health care providers. Both groups reported a willingness to use MT-sDNA and did not perceive major barriers to its use. This preference was especially true of unscreened and younger patients. The majority of providers indicated they would use MT-sDNA if available and that it would improve CRC screening rates. In this population, where colonoscopy access is limited, MT-sDNA has the potential to improve CRC screening adherence.
Collapse
Affiliation(s)
| | - Ian D. Blake
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | | | - Frank D. Sacco
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | |
Collapse
|
5
|
Hannon PA, Vu TT, Santiago PM, Joyner P, Mason C, Harris JR. Prevention Research Center Collaborations With State Departments of Health: Washington State. Am J Prev Med 2017; 52:S246-S249. [PMID: 28215373 DOI: 10.1016/j.amepre.2016.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/11/2016] [Accepted: 07/29/2016] [Indexed: 10/20/2022]
Abstract
State health departments and Prevention Research Centers (PRCs) have complementary mandates and expertise important to improving population health. State health departments manage and administer numerous programs with broad population reach. PRCs bridge dissemination and implementation research and public health practice to improve health programming and outcomes. This paper describes the 15-year partnership between the Washington State Department of Health and the PRC at the University of Washington. Through this partnership, the Washington State Department of Health increases their research and evaluation capacity by working with the University of Washington PRC, and the University of Washington PRC receives opportunities to apply evidence in a variety of practice settings, expand the reach of their research-tested programs to new populations, and form new partnerships. The partnership focused initially on improving colorectal cancer screening rates through increased dissemination and implementation of evidence-based interventions. The partnership scope has grown to include small cancer screening projects in worksites and healthcare systems, Washington's Colorectal Cancer Control Program, breast and cervical cancer screening, hypertension control, and worksite health promotion. The partnership yields three main types of outcomes that strengthen practice and science: (1) findings from each major assessment or evaluation activity, published in the peer-reviewed literature when possible; (2) use of the findings to improve public health practice and impact; and (3) training opportunities for employees of local and state health departments and public health students. PRCs, health departments, and the populations they serve have much to gain from this type of partnership.
Collapse
Affiliation(s)
- Peggy A Hannon
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington;.
| | - Thuy T Vu
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington
| | | | - Pama Joyner
- Office of Healthy Communities, Washington State Department of Health, Olympia, Washington
| | - Caitlin Mason
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington
| | - Jeffrey R Harris
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington
| |
Collapse
|
6
|
Benito L, García M, Binefa G, Mila N, Vidal C, Lluch M, Puig M. Cross-sectional survey on awareness of colorectal cancer and a screening programme for primary health care professionals in Catalonia, Spain. Eur J Cancer Care (Engl) 2016; 25:992-1004. [DOI: 10.1111/ecc.12450] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2015] [Indexed: 11/29/2022]
Affiliation(s)
- L. Benito
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
- IDIBELL; Institute of Biomedical Research; Hospitalet de Llobregat (Barcelona) Spain
- Fundamental Care and Medical-Surgical Nursing Department; School of Nursing; University of Barcelona; Hospitalet de Llobregat (Barcelona) Spain
| | - M. García
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
- IDIBELL; Institute of Biomedical Research; Hospitalet de Llobregat (Barcelona) Spain
| | - G. Binefa
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
| | - N. Mila
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
| | - C. Vidal
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
| | - M.T. Lluch
- Public Health, Mental Health and Perinatal Nursing (Barcelona); School of Nursing; University of Barcelona; Hospitalet de Llobregat (Barcelona) Spain
| | - M. Puig
- Public Health, Mental Health and Perinatal Nursing (Barcelona); School of Nursing; University of Barcelona; Hospitalet de Llobregat (Barcelona) Spain
| | | |
Collapse
|
7
|
Cruz-Correa M, Cordero F, Betancourt JP, Diaz-Algorri Y, Lopez SM, Rivera M, Mosquera R, Carlo-Chevere V, Rodriguez-Quilichini S. Implementation and Outcomes of a Community-Based Educational Program for Colorectal Cancer Prevention in Hispanics. JOURNAL OF FAMILY MEDICINE AND DISEASE PREVENTION 2016; 2. [PMID: 30288455 DOI: 10.23937/2469-5793/1510042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives Colorectal cancer (CRC) is the 2nd most diagnosed cancer and leading cause of cancer death in Puerto Rico. However, CRC screening rates remain low. The aim of this study was to test the effectiveness of a Train-the-Trainers' (TTT) program to develop trainers capable of educating others within their communities about CRC prevention. Methods The TTT program consisted of didactics and seminars to capacitate participants to become trainers in CRC prevention. This project was evaluated using three components: (1) training workshops; (2) community educational sessions; and (3) the participant's experience as a trainer. Pre - and post-tests on CRC screening knowledge were given to TTT participants. Program effectiveness was determined by the pre- and post-tests, number of workshop participants completing a community educational session within three months of training and the number of community members reached. Results Among the 115 total participants, 97 participants took the pre- and post-test. There was a significant difference in the scores for the pre-test (M = 10.56, SD = 2.57) and the post-test (M = 11.43, SD = 1.83) given; t (96) = -4.68, p < 0.001. A total of 955 community members were reached. Participants from the community educational sessions (n = 680) evaluated the program. 77.7% of those participants expressed intent to undergo colonoscopy screening in the future. Conclusions TTT was effective in preparing trainers in CRC prevention. Participants increased their knowledge about CRC prevention and successfully reached members of their community. Utilization of community trainers is an effective alternative to increase CRC education and awareness in Hispanic communities, which may positively impact CRC screening rates in this population.
Collapse
Affiliation(s)
- Marcia Cruz-Correa
- University of Puerto Rico Comprehensive Cancer Center, USA.,University of Puerto Rico School of Medicine, USA.,Puerto Rico Colorectal Cancer Coalition, USA
| | | | | | | | - Sofia M Lopez
- University of Puerto Rico Comprehensive Cancer Center, USA
| | - Mirza Rivera
- University of Puerto Rico Comprehensive Cancer Center, USA.,Graduate School of Public Health, University of Puerto Rico, USA
| | | | | | | |
Collapse
|
8
|
Muliira JK, D'Souza MS, Ahmed SM, Al-Dhahli SN, Al-Jahwari FRM. Barriers to Colorectal Cancer Screening in Primary Care Settings: Attitudes and Knowledge of Nurses and Physicians. Asia Pac J Oncol Nurs 2016; 3:98-107. [PMID: 27981145 PMCID: PMC5123546 DOI: 10.4103/2347-5625.177391] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective: Healthcare providers (HCPs) play a critical role in reducing colorectal cancer (CRC) related morbidity and mortality. This study aimed at exploring the attitudes and knowledge of nurses and physicians working in primary care settings regarding CRC screening. Methods: A total of 142 HCPs (57.7% nurses and 42.3% physicians) participated in a cross-sectional survey. Data were collected using a Self-administered Questionnaire. The participants were clinically experienced (mean = 9.39 years; standard deviation [SD] = 6.13), regularly taking care of adults eligible for CRC screening (62%) and had positive attitudes toward CRC screening (83.1%). Most participants (57%) had low levels of knowledge about CRC screening (mean = 3.23; SD = 1.50). The participants were most knowledgeable about the recommended age for initiating screening (62.7%) and the procedures not recommended for screening (90.8%). Results: More than 55% did not know the frequency of performing specific screening procedures, the upper age limit at which screening is not recommended, and the patients at high-risk for CRC. There were no significant differences between nurses’ and physicians’ attitudes and knowledge. The participants’ perceptions about professional training (odds ratio [OR] = 2.17, P = 0.003), colonoscopy (OR = 2.60, P = 0.014), and double-contrast barium enema (OR = 0.53, P = 0.041), were significantly associated with knowledge about CRC screening. Conclusions: The inadequate knowledge levels among nurses and physicians may be one of the barriers affecting CRC screening. Enhancing HCPs knowledge about CRC screening should be considered a primary intervention in the efforts to promote CRC screening and prevention.
Collapse
Affiliation(s)
- Joshua Kanaabi Muliira
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Samira Maroof Ahmed
- Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | | |
Collapse
|
9
|
Benito-Aracil L, Binefa-Rodriguez G, Milà-Diaz N, Lluch-Canut MT, Puig-Llobet M, Garcia-Martinez M. [Impact of an informative intervention on the colorectal cancer screening program in primary care professionals]. ENFERMERIA CLINICA 2015; 25:223-31. [PMID: 26165782 DOI: 10.1016/j.enfcli.2015.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 05/27/2015] [Accepted: 05/31/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies. METHODS DESIGN Cluster randomized controlled trial. LOCATION Primary Care Centers in L'Hospitalet de Llobregat (Barcelona). PARTICIPANTS Primary Care Professionals (doctors and nurses). INTERVENTION Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages. MAIN MEASUREMENTS Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies. RESULTS The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination. CONCLUSIONS The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening.
Collapse
Affiliation(s)
- Llúcia Benito-Aracil
- Programa de Detección Precoz del Cáncer, Institut Català d'Oncologia - IDIBELL, Hospitalet de Llobregat, Barcelona, España.
| | - Gemma Binefa-Rodriguez
- Programa de Detección Precoz del Cáncer, Institut Català d'Oncologia - IDIBELL, Hospitalet de Llobregat, Barcelona, España
| | - Núria Milà-Diaz
- Programa de Detección Precoz del Cáncer, Institut Català d'Oncologia - IDIBELL, Hospitalet de Llobregat, Barcelona, España
| | - M Teresa Lluch-Canut
- Departamento de Enfermería Salud Pública, Mental y Maternoinfantil, Escuela Universitaria de Enfermería, Universidad de Barcelona, Hospitalet de Llobregat, Barcelona, España
| | - Montse Puig-Llobet
- Departamento de Enfermería Salud Pública, Mental y Maternoinfantil, Escuela Universitaria de Enfermería, Universidad de Barcelona, Hospitalet de Llobregat, Barcelona, España
| | - Montse Garcia-Martinez
- Programa de Detección Precoz del Cáncer, Institut Català d'Oncologia - IDIBELL, Hospitalet de Llobregat, Barcelona, España
| |
Collapse
|
10
|
Omran S, Barakat H, Muliira JK, Bashaireh I, Batiha AM. Assessment of Jordanian Patient's Colorectal Cancer Awareness and Preferences towards CRC Screening: Are Jordanians Ready to Embrace CRC Screening? Asian Pac J Cancer Prev 2015; 16:4229-35. [PMID: 26028078 DOI: 10.7314/apjcp.2015.16.10.4229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the population's level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. MATERIALS AND METHODS A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. RESULTS Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US$) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. CONCLUSIONS Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.
Collapse
Affiliation(s)
- Suha Omran
- Jordan University of Science and Technology, Nursing Adult Health, Irbid, Jordan E-mail :
| | | | | | | | | |
Collapse
|
11
|
Omran S, Barakat H, Muliira JK, Aljadaa N. Knowledge, experiences, and barriers to colorectal cancer screening: a survey of health care providers working in primary care settings. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:53-61. [PMID: 24882440 DOI: 10.1007/s13187-014-0676-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Colorectal cancer (CRC) screening and early detection can effectively decrease the morbidity and mortality associated with this disease. Health care providers (HCPs) working in primary care settings as the first contact with the health care system can play a pivotal role in cancer prevention and screening for early detection. The purpose of this study was to explore the knowledge, experiences, and perceived barriers to CRC screening among HCPs working in primary care settings. A cross-sectional design and a self-administered questionnaire (SAQ) was used to collect data from 236 HCPs working in health centers in Jordan. The 236 HCPs were nurses (45.8%), physicians (45.3%), and others (7.2%). A third of the HCPs (30%) knew the recommended age to begin CRC screening for patients with average risk. Overall physicians scored higher than nurses on questions assessing CRC screening knowledge. The majority of HCPs were not knowledgeable about CRC screening recommendations but believed that CRC is preventable (75.8%). The main perceived barriers to CRC screening were patient's fear of finding out that they have cancer and lack of awareness about CRC screening tests, shortage of trained HCPs to conduct invasive screening procedures, and lack of policy/protocol on CRC screening. HCPs working in primary care settings in Jordan do not have adequate knowledge about CRC screening. There is a need for tailored continuing educational programs and other interventions to improve HCPs' knowledge, as this can increase CRC screening in primary care settings and compliance with current screening guidelines.
Collapse
Affiliation(s)
- Suha Omran
- Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan,
| | | | | | | |
Collapse
|
12
|
Rural-urban differences in the long-term risk of colorectal cancer after adenoma removal: a population-based study. Dig Liver Dis 2014; 46:376-82. [PMID: 24484997 DOI: 10.1016/j.dld.2013.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 12/12/2013] [Accepted: 12/24/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND We investigated the impact of municipality of residence on colonoscopic surveillance and colorectal cancer risk after adenoma resection in a French well-defined administrative area. METHODS This registry-based study included all patients residing in Côte d'Or (n=5769) first diagnosed with colorectal adenomas between January 1, 1990, and December 31, 1999. Information about colonoscopic surveillance and colorectal cancer incidence was collected until December 31, 2003. RESULTS A rural place of residence reduced the probability of colonoscopic surveillance in men [HR=0.89 (95%CI: 0.79-0.99), p=0.041] and in patients without family history of colorectal cancer [HR=0.91(0.82-0.99), p=0.044]. After a median follow-up of 7.7 years, 87 patients developed invasive colorectal cancer. After advanced adenoma removal, the standardized incidence ratio for colorectal cancer was 3.03 (95%CI: 1.92-4.54) for rural patients and 1.87 (95%CI: 1.26-2.66) for urban patients compared with the general population. The risk of colorectal cancer was higher in rural patients than in urban ones only after removal of the initial advanced adenoma [HR=1.73 (95%CI: 1.01-3.00, p=0.048)]. Further adjustment for surveillance colonoscopy, physician location, and other confounders had little impact on these results. CONCLUSION The increased risk of subsequent colorectal cancer after advanced adenoma removal in French rural patients was not explained by a lower rate of colonoscopic surveillance. The role of socio-economic and environmental factors requires further exploration.
Collapse
|
13
|
Getrich CM, Sussman AL, Helitzer DL, Hoffman RM, Warner TD, Sánchez V, Solares A, Rhyne RL. Expressions of machismo in colorectal cancer screening among New Mexico Hispanic subpopulations. QUALITATIVE HEALTH RESEARCH 2012; 22:546-59. [PMID: 22138258 PMCID: PMC3636712 DOI: 10.1177/1049732311424509] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Although national colorectal cancer (CRC) incidence rates have steadily decreased, the rate for New Mexico Hispanics has been increasing, and screening rates are low. We conducted an exploratory qualitative study to determine barriers to CRC screening for New Mexico Hispanics. We found that machismo served as a dynamic influence on men's health-seeking behaviors; however, it was conceptualized differently by two distinct Hispanic subpopulations, and therefore appeared to play a different role in shaping their screening attitudes and behaviors. Machismo emerged as more of an influence for Mexican men, who expressed concern over colonoscopies being potentially transformative and/or stigmatizing, but was not as salient for Hispanos, who viewed the colonoscopy as "strictly medical," and were more concerned with discomfort and pain. Findings from the study highlight the importance of identifying varying characteristics among subpopulations to better understand screening barriers and provide optimal CRC screening counseling in primary care settings.
Collapse
|
14
|
Levy BT, Daly JM, Schmidt EJ, Xu Y. The Need for Office Systems to Improve Colorectal Cancer Screening. J Prim Care Community Health 2012; 3:180-6. [DOI: 10.1177/2150131911423103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Patients generally access colorectal cancer (CRC) screening through primary care physicians. National guidelines recommend CRC screening for adults beginning at age 50, yet one-third of Americans are not up to date. Methods: A self-administered questionnaire was administered to family physicians from 16 practices in a Midwestern state who attended an information session for a randomized study to improve CRC screening. The questionnaire assessed CRC screening practices, knowledge of CRC screening guidelines, and office strategies for improving screening. Results: Of 131 health care providers, 85 (65%) completed the questionnaire. Two-thirds were aware of the CRC screening guidelines; 91% knew that the follow-up interval for screening depends on the test chosen. Twenty-five percent incorrectly stated that a single-sample in-office fecal occult blood test is an acceptable screening test. Only 8% had a written policy regarding CRC screening; 18% had offices that used chart reminders; and 32% had charts organized to easily identify patient screening status. Regarding perceptions, those who agreed that they encourage their office staff to participate in screening estimated that they offer screening to more patients than those who disagreed (82.8% vs 70.2%, P < .0001); in addition, those who agreed with and tried to follow the guidelines estimated that they offer screening to more patients than those who disagreed (77.4% vs 60.5%, P = .004). Conclusion: Although physicians were knowledgeable about CRC screening guidelines, 25% mistakenly believed that single-sample in-office fecal testing was appropriate. There was a striking lack of office systems for identifying eligible patients and facilitating CRC screening.
Collapse
Affiliation(s)
- Barcey T. Levy
- Department of Epidemiology, University of Iowa, Iowa City, USA
- Department of Family Medicine, University of Iowa, Iowa City, USA
| | - Jeanette M. Daly
- Department of Family Medicine, University of Iowa, Iowa City, USA
| | - Erin J. Schmidt
- Department of Family Medicine, University of Iowa, Iowa City, USA
| | - Yinghui Xu
- Department of Family Medicine, University of Iowa, Iowa City, USA
| |
Collapse
|
15
|
Primary care physician compliance with colorectal cancer screening guidelines. Cancer Causes Control 2011; 22:1277-87. [PMID: 21710193 DOI: 10.1007/s10552-011-9801-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 06/13/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess self-reported compliance to colorectal cancer (CRC) screening guidelines among primary care physicians (PCPs) and to assess physician and practice characteristics associated with reported compliance. METHODS Survey data from 984 PCPs in Arizona were used. Self-reported CRC screening practices, recommendations, and compliance with guidelines were assessed. Physician and practice characteristics associated with guideline compliance were also evaluated. RESULTS While 77.5% of physicians reported using national screening guidelines, only 51.7% reported recommendations consistent with the guidelines. Younger physicians were significantly more likely to report compliance with screening guidelines (OR = 1.50, 95% CI = 1.07-2.10) as were female clinicians (OR = 1.46, 95% CI = 1.11-1.92). Physicians practicing in solo (OR = 0.33, 95% CI = 0.19-0.58), group (OR = 0.36, 95% CI = 0.21-0.62), or community health centers (OR = 0.37, 95% CI = 0.17-0.81) were significantly less likely to report following guidelines as compared to those in academic practice. Guideline compliance was higher for fecal occult blood test (FOBT) (65.0%) than colonoscopy (56.7%); overuse of screening for these modalities was reported among 34.4% of physicians. CONCLUSIONS PCPs are not adequately following CRC screening guidelines. Further studies are needed to clarify the reasons for this lack of compliance, especially as guidelines become more complex.
Collapse
|
16
|
O'Donnell S, Goldstein B, DiMatteo MR, Fox SA, John CR, Obrzut JE. Adherence to Mammography and Colorectal Cancer Screening in Women 50–80 Years of Age. Womens Health Issues 2010; 20:343-9. [DOI: 10.1016/j.whi.2010.04.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 04/07/2010] [Accepted: 04/08/2010] [Indexed: 01/11/2023]
|
17
|
Ingrand I, Dujoncquoy S, Beauchant M, Letard JC, Migeot V, Ingrand P. General practitioner and specialist views on colonoscopic screening of first-degree relatives of colorectal cancer patients. Cancer Epidemiol 2009; 33:223-30. [PMID: 19683486 DOI: 10.1016/j.canep.2009.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 05/06/2009] [Accepted: 07/04/2009] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Barriers to targeted colonoscopic screening of first-degree relatives of colorectal cancer patients have been the subject of considerable literature, always as seen from the patient's viewpoint. In the specific context of screening individuals with a family history, physicians may also play a predominant role in motivating their colorectal cancer patients to pass on screening information to their relatives. The aim of this study was to examine the views of general practitioners and specialists regarding barriers and facilitators affecting participation of relatives in colonoscopic screening. METHODS A qualitative study was conducted to collect and analyse information from two focus groups of 4 general practitioners and 9 gastroenterologists respectively, and from semi-structured individual interviews with 10 general practitioners, 2 surgeons and 3 oncologists. An extended focus group of 36 gastroenterologists was organized to validate the results. RESULTS The main barriers to colonoscopic screening of FDRs were associated with lack of direct communication between physicians and FDRs. Physicians needed support in the task of informing index patients and persuading them to transfer information on screening to their FDRs. The general practitioners spoke of their expectations in terms of training in and motivation for promoting screening and the gastroenterologists expressed the wish for patient education material specific to colonoscopy and for systematic post-colonoscopy consultations to inform patients about their results, follow-up and screening their relatives. CONCLUSION The findings, notably the need for specific education materials and for training to improve the motivation of physicians, will help to develop effective interventions intended to increase participation in screening.
Collapse
Affiliation(s)
- Isabelle Ingrand
- Epidemiology and Biostatistics, INSERM CIC-P 802, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
| | | | | | | | | | | |
Collapse
|
18
|
Bazargan M, Ani C, Bazargan-Hejazi S, Baker RS, Bastani R. Colorectal cancer screening among underserved minority population: discrepancy between physicians' recommended, scheduled, and completed tests. PATIENT EDUCATION AND COUNSELING 2009; 76:240-247. [PMID: 19150198 DOI: 10.1016/j.pec.2008.12.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 11/18/2008] [Accepted: 12/06/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This study examines the correlates of: (1) health care provider recommendation of CRC testing; (2) provider scheduling for recommended CRC testing using sigmoidoscopy, colonoscopy, or double-contrast barium enema; and (3) adherence to CRC scheduling among underserved minority populations. METHODS Medical record and schedule logbook reviews and interviewer-administered surveys. SETTING Large urban safety-net, outpatient primary care setting in Los Angeles County. PARTICIPANTS 306 African-American and Latino patients aged 50 years and older. RESULTS A vast majority of minority patients do not receive standard CRC testing in urban safety-net primary care settings. Of those patients who were actually scheduled for sigmoidoscopy or colonoscopy, almost half completed the procedure. Completing CRC testing was associated with marital status, co-morbid chronic physical conditions, number of risk factors for colorectal cancer, and lower perceived barriers to CRC testing. CONCLUSION Effective interventions to reduce CRC mortality among underserved minority populations require an integrated approach that engages patients, providers, and health care systems. PRACTICE IMPLICATIONS Designing interventions that (1) increase physician-patient communications for removing patients' perceived barriers for CRC testing and (2) promote a non-physician-based navigator system that reinforces physicians' recommendation are strongly recommended.
Collapse
Affiliation(s)
- Mohsen Bazargan
- Department of Family Medicine, Charles Drew University of Medicine & Science, Los Angeles, CA 90059, USA.
| | | | | | | | | |
Collapse
|