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Showing content from https://pubmed.ncbi.nlm.nih.gov/31049411/ below:

GPs' perspectives on colorectal cancer screening and their potential influence on FIT-positive patients: an exploratory qualitative study from a Dutch context

Affiliations

• ¹ Medical Anthropologist and Sociologist, PhD candidate, Department of General Practice, Cancer Center Amsterdam, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ² Final Year Medical Student, Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ³ Assistant Professor, Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ⁴ Professor, Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
• ⁵ Postdoctoral Researcher, Department of General Practice, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ⁶ Professor, Department of General Practice, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

• PMID: 31049411
• PMCID: PMC6480863
• DOI: 10.3399/bjgpopen18X101631

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Lucinda Bertels et al. BJGP Open. 2019.

• ¹ Medical Anthropologist and Sociologist, PhD candidate, Department of General Practice, Cancer Center Amsterdam, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ² Final Year Medical Student, Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ³ Assistant Professor, Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ⁴ Professor, Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
• ⁵ Postdoctoral Researcher, Department of General Practice, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
• ⁶ Professor, Department of General Practice, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

• PMID: 31049411
• PMCID: PMC6480863
• DOI: 10.3399/bjgpopen18X101631

Item in Clipboard

Background: In the Dutch colorectal cancer (CRC) screening programme, individuals receive a faecal immunochemical test (FIT) to do at home. After a positive FIT result, a follow-up colonoscopy is recommended to identify CRC or advanced adenomas (AA). GPs may influence their patients' decisions on adherence to follow-up by colonoscopy.

Aim: To explore GPs' perspectives on the CRC screening programme and their potential influence on FIT-positive patients to follow up with the recommended colonoscopy.

Design & setting: Semi-structured interviews among GPs in Amsterdam, the Netherlands.

Method: GPs were approached using purposive sampling. Analysis was performed on 11 interviews using open coding and constant comparison.

Results: All interviewed GPs would recommend FIT-positive patients without obvious contraindications to adhere to a follow-up colonoscopy. If patients were likely to be distressed by a positive FIT result, most GPs described using reassurance strategies emphasising a low cancer probability. Most GPs stressed the probability of false-positive FIT results. Some described taking a positive screening result in CRC screening less seriously than one in breast cancer screening. Most GPs underestimated CRC and AA probabilities after a positive FIT result. When told the actual probabilities, some stated that this knowledge might change the way they would inform patients.

Conclusion: These results imply that some of the interviewed GPs have too low a perception of the risk associated with a positive FIT result, which might influence their patients' decision-making. Simply informing GPs about the actual rates of CRC and AA found in the screening programme might improve this risk perception.

Keywords: Colorectal Cancer Screening; Colorectal Neoplasms; Early Detection of Cancer; Family Practice; Primary Health Care; Qualitative Research.

PubMed Disclaimer

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