Involvement of general practitioners in mass screening. Experience of a colorectal cancer mass screening programme in the Calvados region (France)

• Published in: European journal of cancer prevention 1993-05, Vol.2 (3), p.229-232
• Main Authors: Launoy, G, Veret, J-L, Gignoux, M, Richir, B, Reaud, J-M, Ollivier, V, Valla, A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Attitude to Health; Biological and medical sciences; Colonic Neoplasms - prevention & control; Family Practice; Female; France; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Mass Screening; Medical sciences; Middle Aged; Motivation; Occult Blood; Patient Compliance; Physician-Patient Relations; Practice Patterns, Physicians; Rectal Neoplasms - prevention & control; RESEARCH PAPERS; Sex Factors; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors
• ISSN: 0959-8278; 1473-5709
• DOI: 10.1097/00008469-199305000-00006

Good compliance with screening programmes is essential and experience from ongoing studies points to the importance of involving general practitioners (GPs). The aim of this study was to evaluate factors influencing the participation of GPs in a screening programme, as well as acceptance of the test by the population. Fifty GPs were randomly chosen among the 117 practices of three districts in Calvados (France) where Haemoccut test-based mass screening for colorectal cancer was underway. Each GP was asked to fill in a personal questionnaire as well as a detailed record for each patient between 45 and 74 years seen in the practice during a 1-week period. The GPs offered the test to 95% of the patients. The overall refusal rate was 7.8%, and was higher in women than in men (9.9% vs 5.9%; P < 0.05). Manual workers had a lower refusal rate than other occupational groups (2.5% vs 8.5%; P < 0.05). The GP's motivation was an important factor in patient compliance: the refusal rate was 5.4% in the case of highly motivated GPs, against 20.0% when the GP was poorly motivated (P < 0.01). GP motivation was higher in urban than in rural areas (P < 0.05) but did not depend on sex, age or the duration or type of practice. According to the GPs, motivating factors were the perceived need for screening, involvement in planning the campaign, and regular feedback. Conversely, a lack of time and the possibility of false-negative results were the most important impediments. This study demonstrates that patient compliance is closely linked to practitioner motivation. Good GP motivation requires specific organization, eg involvement in planning the screening programmes from the outset, continual feedback on results, and prior training course.