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The Role of GPs in Increasing Compliance to Colorectal Cancer Screening: A Randomised Controlled Trial (Italy)

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Abstract

Aims To assess the effect of the provider (GPs versus hospital) on the compliance in returning the faecal occult blood test. To analyse the characteristics of the GP associated with high compliance among his beneficiaries.

Methods A questionnaire about screening attitudes was mailed to the 1192 GPs working in 13 districts of the Lazio region. We asked the GPs to participate in a randomised trial, we sampled 130 GPs and about 1/10 of the GPs’ 50–75 year old beneficiaries (n = 3657) were invited to be screened at the GP office and 1/10 (3675) at the nearest gastroenterology centre.

Results 58.5% of the GPs completed the questionnaire and 22.7% agreed to participate in the trial. The compliance in the GP arm was 50%, in the hospital arm 16% (RR 3.4; 95% CI: 3.13–3.70). There was a high variability in the compliance obtained by the GPs. GPs with more than 25 patients visited/day and those incorrectly recommended screening of colorectal cancer obtained a lower compliance (OR 0.74, 95% CI: 0.57–0.95 and OR 0.76, 95% CI: 0.59–0.97, respectively).

Conclusions The involvement of GPs in colorectal cancer screening can be very effective to enhance the compliance, but the effectiveness is dependent on their willingness to be involved.

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References

  1. European Union. Council Recommendation of 2 December 2003 on cancer screening. 2003/878/EC.

  2. L Madlensky V Goel J Polzer FD Ashbury (2003) ArticleTitleAssessing the evidence for organised cancer screening programmes Eur J Cancer 39 1648–1653 Occurrence Handle1:STN:280:DC%2BD3szlsFCguw%3D%3D Occurrence Handle12888358 Occurrence Handle10.1016/S0959-8049(03)00315-0

    Article  CAS  PubMed  Google Scholar 

  3. BP Towler L Irwig P Glasziou D Weller J Kewenter (2000) ArticleTitleScreening for colorectal cancer using the faecal occult blood test, hemoccult Cochrane Database Syst Rev 2 CD001216 Occurrence Handle10796760

    PubMed  Google Scholar 

  4. InstitutionalAuthorNameAmerican Gastroenterological Association (1997) ArticleTitleColorectal cancer screening:clinical guidelines and rationale Gastroenterology 112 594–642

    Google Scholar 

  5. G Pye M Christie JO Chamberlain SM Moss JD Hardcastle (1988) ArticleTitleA comparison of methods for increasing compliance within a general practitioner based screening project for colorectal cancer and the effect on practitioner workload J Epidemiol Community Health 42 66–71 Occurrence Handle1:STN:280:BieA3s3itVw%3D Occurrence Handle3418289

    CAS  PubMed  Google Scholar 

  6. R Jepson A Clegg C Forbes R Lewis A Sowden J Kleijnen (2000) ArticleTitleThe determinants of screening uptake and interventions for increasing uptake:a systematic review Health Technol Assess 4 IssueIDi–vii 1–133

    Google Scholar 

  7. CN Klabunde PS Frame A Meadow E Jones M Nadel SW Vernon (2003) ArticleTitleA national survey of pri-mary care physicians’ colorectal cancer screening recommendations and practices Prev Med 36 352–362 Occurrence Handle12634026 Occurrence Handle10.1016/S0091-7435(02)00066-X

    Article  PubMed  Google Scholar 

  8. ST Hawley B Levin SW Vernon (2001) ArticleTitleColorectal cancer screening by primary care physicians in two medical care organizations Cancer Detect Prev 25 309–318 Occurrence Handle1:STN:280:DC%2BD3MzmsVKjuw%3D%3D Occurrence Handle11425273

    CAS  PubMed  Google Scholar 

  9. MJ Sladden JE Ward (1999) ArticleTitleAustralian general practitioners’ views and use of colorectal cancer screening tests Med J Aust 170 110–113 Occurrence Handle1:STN:280:DyaK1M7msVGitw%3D%3D Occurrence Handle10065121

    CAS  PubMed  Google Scholar 

  10. DV Schapira RJ Pamies NB Kumar AH Herold DJ Durme ParticleVan LJ Woodward RG Roetzheim (1993) ArticleTitleCancer screening. Knowledge, recommendations, and practices of physicians Cancer 71 839–843 Occurrence Handle1:STN:280:ByyC287isFM%3D Occurrence Handle8431866

    CAS  PubMed  Google Scholar 

  11. VK Sharma R Vasudeva CW Howden (2000) ArticleTitleColorectal cancer screening and surveillance practices by primary care physicians:results of a national survey Am J Gastroenterol 95 1551–1556 Occurrence Handle1:STN:280:DC%2BD3czltFSqsQ%3D%3D Occurrence Handle10894595

    CAS  PubMed  Google Scholar 

  12. SC Lemon JG Zapka B Estabrook S Erban R Luckmann (2003) ArticleTitleScreening for colorectal cancer on the front line Am J Gastroenterol 98 915–923 Occurrence Handle12738477 Occurrence Handle10.1111/j.1572-0241.2003.07360.x

    Article  PubMed  Google Scholar 

  13. A Schattner A Gilad (2002) ArticleTitlePrimary care physicians’ awareness and implementation of screening guidelines for colorectal cancer Prev Med 35 447–452 Occurrence Handle12431893 Occurrence Handle10.1006/pmed.2002.1101

    Article  PubMed  Google Scholar 

  14. A Federici F Bartolozzi S Farchi P Borgia G Guasticchi (2005) ArticleTitleSurvey on colorectal cancer screening knowledge, attitudes and practices of general practice physicians in Lazio, Italy Prev Med 41 30–35 Occurrence Handle15916990 Occurrence Handle10.1016/j.ypmed.2004.11.010

    Article  PubMed  Google Scholar 

  15. SR Cole GP Young (2001) ArticleTitleEffect of dietary restriction on participation in faecal occult blood test screening for colorectal cancer Med J Aust 175 195–198 Occurrence Handle1:STN:280:DC%2BD3MrktVKhsA%3D%3D Occurrence Handle11587278

    CAS  PubMed  Google Scholar 

  16. BD Powe (2002) ArticleTitlePromoting fecal occult blood testing in rural African American women Cancer Pract 10 139–146 Occurrence Handle11972568 Occurrence Handle10.1046/j.1523-5394.2002.103008.x

    Article  PubMed  Google Scholar 

  17. LC Friedman TE Everett L Peterson KI Ogbonnaya V Mendizabal (2001) ArticleTitleCompliance with fecal occult blood test screening among low-income medical outpatients:a randomized controlled trial using a videotaped intervention J Cancer Educ 16 85–88 Occurrence Handle1:STN:280:DC%2BD38%2FhvVGhtQ%3D%3D Occurrence Handle11440068

    CAS  PubMed  Google Scholar 

  18. L Ore L Hagoel I Lavi G Rennert (2001) ArticleTitleScreening with faecal occult blood test (FOBT) for colorectal cancer:assessment of two methods that attempt to improve compliance Eur J Cancer Prev 10 251–256 Occurrence Handle1:STN:280:DC%2BD3MznsFyrsQ%3D%3D Occurrence Handle11432712 Occurrence Handle10.1097/00008469-200106000-00008

    Article  CAS  PubMed  Google Scholar 

  19. JL Fernandez M Gallegos A Brochero C Arevalo H Piccioni H Gutierrez Galiana (1999) ArticleTitle[Screening for colorectal cancer with an immunochemical fecal occult blood test] Acta Gastroenterol Lati-noam 29 73–78 Occurrence Handle1:STN:280:DyaK1MvitVGnug%3D%3D

    CAS  Google Scholar 

  20. S Nichols E Koch RC Lallemand RJ Heald L Izzard D Machin MA Mullee (1986) ArticleTitleRandomised trial of compliance with screening for colorectal cancer Br Med J (Clin Res Ed) 293 107–110 Occurrence Handle1:STN:280:BimB2s%2FovVI%3D

    CAS  Google Scholar 

  21. SR Cole GP Young A Esterman B Cadd J Morcom (2003) ArticleTitleA randomised trial of the impact of new faecal haemoglobin test technologies on population participation in screening for colorectal cancer J Med Screen 10 117–122 Occurrence Handle1:STN:280:DC%2BD3svotlGmtw%3D%3D Occurrence Handle14561262 Occurrence Handle10.1258/096914103769011003

    Article  CAS  PubMed  Google Scholar 

  22. SR Cole GP Young D Byrne JR Guy J Morcom (2002) ArticleTitleParticipation in screening for colorectal cancer based on a faecal occult blood test is improved by endorsement by the primary care practitioner J Med Screen 9 147–152 Occurrence Handle1:STN:280:DC%2BD3s%2FktlCnsg%3D%3D Occurrence Handle12518003 Occurrence Handle10.1136/jms.9.4.147

    Article  CAS  PubMed  Google Scholar 

  23. S Vinker S Nakar E Rosenberg E Kitai (2002) ArticleTitleThe role of family physicians in increasing annual fecal occult blood test screening coverage:a prospective intervention study Isr Med Assoc J 4 424–425 Occurrence Handle12073414

    PubMed  Google Scholar 

  24. P Giorgi Rossi A Federici F Bartolozzi S Farchi P Borgia G Guastcchi (2005) ArticleTitleTrying to improve the compliance to colorectal cancer screening:a complex study design for a complex planning question Cont Clin Trial 26 323–330

    Google Scholar 

  25. A Federici P Giorgi Rossi P Borgia F Bartolozzi S Farchi G Gausticchi (2005) ArticleTitleThe immunochemical faecal occult blood test leads to higher compliance than the guaiac for colorectal cancer screening programs:a cluster randomised controlled trial J Med Screen 12 83–88 Occurrence Handle15949119 Occurrence Handle10.1258/0969141053908357

    Article  PubMed  Google Scholar 

  26. Epi-data Freeware, Epidata software:release v2.1, Dec 2001 [cited, 5 April 2004], http://www.epidata.dk/index.htm.

  27. Stata 7.0, Statistics/Data Analysis. Stata Corporation, 4905 Lakeway Drive, College Station, Texas 77845, USA.

  28. J Zhang KF Yu (1998) ArticleTitleWhat’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes JAMA 280 1690–1691 Occurrence Handle1:STN:280:DyaK1M%2FkvVynsw%3D%3D Occurrence Handle9832001 Occurrence Handle10.1001/jama.280.19.1690

    Article  CAS  PubMed  Google Scholar 

  29. Hsieh FY (1997) Sample size formulae for intervention studies with the cluster as unit of randomization. Stat Med. 1988; 7:1195–1201. Erratum in:Stat Med 15;16:1300.

    Google Scholar 

  30. AR Hart TL Barone SP Gay A Inglis L Griffin CA Tallon JF Mayberry (1997) ArticleTitleThe effect on compliance of a health education leaflet in colorectal cancer screening in general practice in central England J Epidemiol Community Health 51 187–191 Occurrence Handle1:STN:280:ByiA2c%2FhsVQ%3D Occurrence Handle9196650

    CAS  PubMed  Google Scholar 

  31. J Wardle S Williamson K McCaffery S Sutton T Taylor R Edwards W Atkin (2003) ArticleTitleIncreasing at-tendance at colorectal cancer screening:testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults Health Psychol 22 99–105 Occurrence Handle12558207

    PubMed  Google Scholar 

  32. G Grazzini G Castiglione C Ciabattoni F Franceschini D Giorgi S Gozzi P Mantellini P Lopane M Perco T Rubeca P Salvadori CB Visioli M Zappa (2004) ArticleTitleColorectal cancer screening programme by faecal occult blood test in Tuscany:first round results Eur J Cancer Prev 13 IssueID1 19–26 Occurrence Handle1:STN:280:DC%2BD2c7otFOisw%3D%3D Occurrence Handle15075784

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Agency for Public Health, Lazio Region, via di S. Costanza 53, 00198, Rome, Italy

    Antonio Federici, Paolo Giorgi Rossi, Sara Farchi, Piero Borgia & Gabriella Guastcchi

  2. Campus Biomedico, University Hospital, Rome, Italy

    Francesco Bartolozzi

Authors
  1. Antonio Federici
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  2. Paolo Giorgi Rossi
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  3. Francesco Bartolozzi
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  4. Sara Farchi
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  5. Piero Borgia
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  6. Gabriella Guastcchi
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Correspondence to Paolo Giorgi Rossi.

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Federici, A., Rossi, P.G., Bartolozzi, F. et al. The Role of GPs in Increasing Compliance to Colorectal Cancer Screening: A Randomised Controlled Trial (Italy). Cancer Causes Control 17, 45–52 (2006). https://doi.org/10.1007/s10552-005-0380-9

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  • DOI: https://doi.org/10.1007/s10552-005-0380-9

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