Format

Send to

Choose Destination
BJGP Open. 2019 Mar 20;3(1):bjgpopen18X101631. doi: 10.3399/bjgpopen18X101631. eCollection 2019 Apr.

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

Author information

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.

Abstract

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

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center