TY - JOUR
T1 - Colorectal cancer screening practise is influenced by ethnicity of medical practitioner and patient
AU - Koo, Jenn Hian
AU - You, Matthew Yibin
AU - Liu, Ken
AU - Athureliya, Maneesha D.
AU - Tang, Catherine W Y
AU - Redmond, Diane M.
AU - Connor, Susan J.
AU - Leong, Rupert W L
PY - 2012
Y1 - 2012
N2 - Background and Aim: Colorectal cancer (CRC) screening improves survival and requires appropriate recommendation by general practitioners (GPs). Screening practises may be influenced by barriers related to ethnicity and training. Methods: A mail survey assessed GPs' practises and the barriers towards CRC screening. The association of screening practises and demography, including GP ethnicity, medical training and practise characteristics, were evaluated. Results: Of 212 GPs (median age 54years, 73% men, 27% Caucasian, 38% foreign graduates), 87% agreed that fecal occult blood test (FOBT) screening improved survival in the average-risk patient. Considerable variations existed in the starting age (40-49years: 31%; 50years: 65%) and frequency (1-2years: 77%; 3-5years: 22%) of screening. FOBT was used for indications other than screening: anemia (59%), altered bowel habits (54%), abdominal pain (24%), and rectal bleeding (23%), and these were significantly more frequent in Asian GPs independent of medical training. GPs were less likely to recommend screening to immigrants, and most reported that immigrants were less likely to participate. More Asian and Middle Eastern GPs reported a major barrier with FOBT inaccuracy compared with Caucasian GPs (22% vs 9%, P=0.03; and 27% vs 9%, P=0.03, respectively). Conclusions: Considerable differences existed in GPs' CRC screening practises. Indications for use of FOBT and the subsequent investigation of a positive FOBT also varied according to GPs' ethnicity, independent of medical training. Patient's ethnicity and associated language and cultural barriers may affect screening uptake, which may negatively affect the health of immigrants. Resources and culture-specific interventions are recommended to improve overall screening participation.
AB - Background and Aim: Colorectal cancer (CRC) screening improves survival and requires appropriate recommendation by general practitioners (GPs). Screening practises may be influenced by barriers related to ethnicity and training. Methods: A mail survey assessed GPs' practises and the barriers towards CRC screening. The association of screening practises and demography, including GP ethnicity, medical training and practise characteristics, were evaluated. Results: Of 212 GPs (median age 54years, 73% men, 27% Caucasian, 38% foreign graduates), 87% agreed that fecal occult blood test (FOBT) screening improved survival in the average-risk patient. Considerable variations existed in the starting age (40-49years: 31%; 50years: 65%) and frequency (1-2years: 77%; 3-5years: 22%) of screening. FOBT was used for indications other than screening: anemia (59%), altered bowel habits (54%), abdominal pain (24%), and rectal bleeding (23%), and these were significantly more frequent in Asian GPs independent of medical training. GPs were less likely to recommend screening to immigrants, and most reported that immigrants were less likely to participate. More Asian and Middle Eastern GPs reported a major barrier with FOBT inaccuracy compared with Caucasian GPs (22% vs 9%, P=0.03; and 27% vs 9%, P=0.03, respectively). Conclusions: Considerable differences existed in GPs' CRC screening practises. Indications for use of FOBT and the subsequent investigation of a positive FOBT also varied according to GPs' ethnicity, independent of medical training. Patient's ethnicity and associated language and cultural barriers may affect screening uptake, which may negatively affect the health of immigrants. Resources and culture-specific interventions are recommended to improve overall screening participation.
KW - Colorectal cancer
KW - Ethnicity
KW - General practitioner
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=81855215941&partnerID=8YFLogxK
U2 - 10.1111/j.1440-1746.2011.06872.x
DO - 10.1111/j.1440-1746.2011.06872.x
M3 - Article
C2 - 21793910
AN - SCOPUS:81855215941
SN - 0815-9319
VL - 27
SP - 390
EP - 396
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 2
ER -