[Colorectal cancer screening: a survey of French general practitioners]

Abstract

Aim: To determine knowledge, beliefs, self-reported practices and wishes of French general practitioners regarding colorectal cancer screening before the start of an organized screening program.

Methods: A postal survey of the 600 general practitioners of the Haut-Rhin area was made in 2002.

Results: Response rate was 62%. Eighty-five% asked routinely their patients about their family history of colorectal cancer. Colorectal cancer screening was routinely proposed by 92% of practitioners to individuals with a family history (86% with colonoscopy) and by 20% to individuals without family history (69% with faecal occult blood test). Seventy-five% did not know French consensus conference guidelines on colorectal cancer screening. Fifty-three% ordered routinely faecal occult blood testing, mostly for the screening of individuals with family history and for the evaluation of symptoms, mainly iron-deficiency anemia and weight loss. Seventy-seven% would explore with colonoscopy subjects with positive faecal occult blood test. Fifty-four% had personally undergone screening. Fifty-six% considered that mass screening could reduce a lot colorectal cancer mortality and most of them agreed with the forthcoming organized colorectal cancer mass screening program.

Conclusions: Screening for colorectal cancer is ordered less often than screening for female cancers. General practitioners are unaware of current guidelines. Beliefs and practices vary considerably and faecal occult blood testing is often inappropriately prescribed. Medical education concerning screening is needed. Colorectal cancer screening guidelines and policy should be clarified in France.