TY - JOUR
T1 - GPs' perspectives on colorectal cancer screening and their potential influence on FIT-positive patients: An exploratory qualitative study from a Dutch context
AU - Bertels, Lucinda
AU - van der Heijden, Sientje
AU - Hoogsteyns, Maartje
AU - Dekker, Evelien
AU - van Asselt, Kristel
AU - van Weert, Henk
AU - Knottnerus, Bart
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85080980976&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31049411
U2 - https://doi.org/10.3399/bjgpopen18X101631
DO - https://doi.org/10.3399/bjgpopen18X101631
M3 - Article
C2 - 31049411
SN - 2398-3795
VL - 3
JO - BJGP Open
JF - BJGP Open
IS - 1
M1 - 18X101631
ER -