Knowledge, Experiences, and Barriers to Colorectal Cancer Screening: A Survey of Health Care Providers Working in Primary Care Settings

Abstract

Colorectal cancer (CRC) screening and early detection can effectively decrease the morbidity and mortality associated with this disease. Health care providers (HCPs) working in primary care settings as the first contact with the health care system can play a pivotal role in cancer prevention and screening for early detection. The purpose of this study was to explore the knowledge, experiences, and perceived barriers to CRC screening among HCPs working in primary care settings. A cross-sectional design and a self-administered questionnaire (SAQ) was used to collect data from 236 HCPs working in health centers in Jordan. The 236 HCPs were nurses (45.8%), physicians (45.3%), and others (7.2%). A third of the HCPs (30%) knew the recommended age to begin CRC screening for patients with average risk. Overall physicians scored higher than nurses on questions assessing CRC screening knowledge. The majority of HCPs were not knowledgeable about CRC screening recommendations but believed that CRC is preventable (75.8%). The main perceived barriers to CRC screening were patient's fear of finding out that they have cancer and lack of awareness about CRC screening tests, shortage of trained HCPs to conduct invasive screening procedures, and lack of policy/protocol on CRC screening. HCPs working in primary care settings in Jordan do not have adequate knowledge about CRC screening. There is a need for tailored continuing educational programs and other interventions to improve HCPs' knowledge, as this can increase CRC screening in primary care settings and compliance with current screening guidelines.

Assessment of Knowledge and Perceived Barriers About Colorectal Cancer Screening Among Ministry of Health Primary Health Care Physicians in Makkah Al-Mokarramah City, 2016.

“…(1) Colonoscopy was the primary screening method to choose for follow-up after positive FOBT and flexible sigmoidoscopy (55% ,70%) respectively, which consistent with other studies that colonoscopy is the golden standard screening test. (1,13,20,23,25,29) The findings of the current study are agreed with other studies and demonstrated the fact that physicians had good knowledge about the age of running CRC screening. However, there are varieties in the rate of specific knowledge about the frequency of screening and age to stop, this lake of knowledge work as a significant barrier to CRC screening .…”

“…(1,13,20) Regarding the comparison of knowledge levels and demographic data, there was significant association between medical degree and knowledge level where physicians with board certificates were more knowledgeable than others with diploma or bachelor, this consistent with Riyadh study, (1) and USA study. (23) In the current study female physicians were more aware than male which consistent with Saskatchewan study, (28) and contrast Riyadh study.…”

“…On the other hand, the results in Jordan study was lower for all three times ( 15.1%, 10.3% & 3.4%). (13) Also in Oman study, 53.3% and 43.3% reported the right answers for FOBT and flexible sigmoidoscopy, while only 8.3% reported the correct answer for colonoscopy. (23) One-third (34.7%) reported the need for three samples for FOBT; this is lower than the results from Saudi study (52.7%).…”

“…(1) In contrast, the results in Jordan study was lower (24.1% and 7.3%) for starting and stopping age respectively. (13) More than half reported doing FOBT yearly, 43.4% recorded doing colonoscopy every ten years and less than quarter reported doing flexible sigmoidoscopy between 2-5 years. Similar results found in Riyadh study for FOBT and colonoscopy (53.1% & 43.8%).…”

“…Similar results were found in Saudi study (67.5%,62.8%,76.9% & 60.7%) respectively , (1) and in Jordan study (73%,66%,63% & 68%) respectively. (13) This finding highlighted the need for national guidelines, which physicians can be followed and never depend on their anticipation and suspicious, in Riyadh study, the results showed that practitioner's who followed USPSTF or CDC guidelines had better knowledge score than other who don't follow any instruction, (1) In Oman study, the authors reported that physicians and nurses who had the perfect level of knowledge followed the guidelines recommendation and encouraged the patient to screen. (23) In In Saudi Arabia, Alsanea N and his colleagues conducted a study about the need for guidelines for CRC screening, where the Saudi Centre for Evidence-Based Healthcare created a team of experts from various official institutions and associations.…”