GP participation in increasing uptake in a national bowel cancer screening programme: the PEARL project

Benton, Sally C; Butler, P; Allen, Katy; Chesters, M; Rickard, Sally; Stanley, S; Roope, Richard; Vulkan, Daniel; Duffy, Stephen W.

doi:10.1038/bjc.2017.129

Cited by 28 publications

(33 citation statements)

References 19 publications

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“…Another would see general practitioners performing the risk assessment, creating the opportunity to discuss and then manage modifiable risk factors. The latter approach may also result in greater uptake of the risk assessment and resulting screening recommendations, as demonstrated by studies involving general practitioner endorsement of iFOBT ( 51 , 52 ). Potential barriers to this option include upskilling the current workforce and integration into current general practitioner workflows ( 53 ).…”

Section: Discussionmentioning

confidence: 99%

The Impact of a Comprehensive Risk Prediction Model for Colorectal Cancer on a Population Screening Program

Saya

Emery

Dowty

et al. 2020

JNCI Cancer Spectrum

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Background In many countries, population colorectal cancer (CRC) screening is based on age and family history, though more precise risk prediction could better target screening. We examined the impact of a CRC risk prediction model (incorporating age, sex, lifestyle, genomic and family history factors) to target screening under several feasible screening scenarios. Methods We estimated the model’s predicted CRC risk distribution in the Australian population. Predicted CRC risks were categorised into screening recommendations under three proposed scenarios to compare to current recommendations: a) highly tailored; b) three risk categories; c) four sex-specific risk categories. Under each scenario, for 35-74-year-olds, we calculated the number of CRC screens by immunochemical faecal occult blood testing (iFOBT) and colonoscopy, and the proportion of predicted CRCs over ten years in each screening group. Results Currently, 1.1% of 35-74-year-olds are recommended screening colonoscopy and 56.2% iFOBT. 5.7% and 83.2% of CRCs over ten years were predicted to occur in these groups respectively. For the scenarios: a) colonoscopy was recommended to 8.1% and iFOBT to 37.5%, with 36.1% and 50.1% of CRCs in each group; b) colonoscopy recommended to 2.4% and iFOBT to 56.0%, with 13.2% and 76.9% of cancers in each group; c) colonoscopy recommended to 5.0% and iFOBT to 54.2%, with 24.5% and 66.5% of cancers in each group. Conclusions A highly tailored CRC screening scenario results in many fewer screens but more cancers in those unscreened. Category-based scenarios may provide good balance between number of screens and cancers detected and be simpler to implement.

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Section: Discussionmentioning

confidence: 99%

The Impact of a Comprehensive Risk Prediction Model for Colorectal Cancer on a Population Screening Program

Saya

Emery

Dowty

et al. 2020

JNCI Cancer Spectrum

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“…GP surgeries are advised to add a personal message to letters on the grounds that GP endorsement encourages patients to accept the invitation of screening. [21,22] Even though a caveat is added that the decision to accept cervical screening is 'your choice', this is at odds with the pragmatic implication of the rest of the message.…”

Section: Patient Choicementioning

confidence: 99%

Non-maleficence and the ethics of consent to cancer screening

Elton

2020

J Med Ethics

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Cancer screening programmes cause harm to individuals via overdiagnosis and overtreatment, even where they confer population-level benefit. Screening thus appears to violate the principle of non-maleficence, since it entails medically unnecessary harm to individuals. Can consent to screening programmes negate the moral significance of this harm? In therapeutic medical contexts, consent is used as a means of rendering medical harm morally permissible. However, in this paper, I argue that it is unclear that the model of consent used within therapeutic medicine can be applied unproblematically to preventive medicine. Invitation to screening changes the pragmatic norms and expectations of the patient–doctor encounter such that two key principles of consent may be violated. First, the pragmatics of a medical invitation are such that patients may fail to be adequately informed, since patients appear to assume medical invitations are made with their best interests in mind, even where information to the contrary is outlined. Second, screening invitations may place pressure on patients; in the context of a medical encounter, to make an invitation to screening may constitute an inducement to accept. In order to be sure that a patient’s consent to a screening invitation is valid, we must make clear to patients that their decision to accept screening may be shaped not only by how information about screening is presented, but by the pragmatic form of the invitation itself.

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“…The PEARL study also highlight role of the GP for cancer screening and demonstrated that people encouraged by a GP were more likely to respond to a screening invitation. Moreover, patients who ignored reminder letters from prevention centres might still have reacted to an endorsed reminder from their GP [27].…”

Section: Role Of the Gp In Screening For Gastrointestinal Cancermentioning

confidence: 99%

Awareness of gastrointestinal tract malignancies among the population of Lublin province (Eastern Poland) – A cross-sectional study

Berbecka

Kolasińska-Bzoma²,

Kolasinska-Gliwa³

et al. 2020

Ann Agric Environ Med.

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Introduction. Currently, malignancies are the most severe medical problems worldwide. Numerous, already known risk factors in carcinogenesis could be potentially avoided. Some cancer risk factors have been recognized and have become the targets of primary prophylaxis. Objective. The aim of the study was to ascertain the state of knowledge about risk factors, primary prevention and early detection of malignancies of gastrointestinal tract (GIT) in the urban and rural population of the Lublin province in Eastern Poland. Materialas and method. The study was cross-sectional. The originally designed questionnaire was applied to the group of 1,352 patients, representatives of both the rural and urban environments of the Lublin province during random appointments with their general practitioner (GP). Results. The study showed low awareness of the issues connected with GIT malignancies within the studied group. The problem was particulary apparent in the rural population. Conclusions. In order to raise general awareness of cancer, different means should be applied in urban and rural populations. GPs and the media were found to have the leading rols in the promotion of primary prevention.

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GP participation in increasing uptake in a national bowel cancer screening programme: the PEARL project

Cited by 28 publications

References 19 publications

The Impact of a Comprehensive Risk Prediction Model for Colorectal Cancer on a Population Screening Program

The Impact of a Comprehensive Risk Prediction Model for Colorectal Cancer on a Population Screening Program

Non-maleficence and the ethics of consent to cancer screening

Awareness of gastrointestinal tract malignancies among the population of Lublin province (Eastern Poland) – A cross-sectional study

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