Awareness of Colorectal Cancer Screening in
Primary Care Physicians
Kessarin Thanapirom MD*,
Sombat Treeprasertsuk MD*, Rungsun Rerknimitr MD*
Affiliation :
* Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : Colorectal cancer is one of the leading causes of cancer related death worldwide. Primary care physicians play
an important role in colorectal cancer screening. However, the awareness and knowledge on the methods for colorectal
cancer screening are still lacking. The authors aimed to assess Thai primary care physicians’ knowledge and practice
regarding colorectal cancer screening.
Material and Method: Between October and December 2010, questionnaires were distributed to 447 Thai physicians. The
questionnaires included demographic data, self-responded knowledge, and practice. Their responses were analyzed.
Results : Three hundred eighty seven physicians completed the questionnaires (86.5% response rate). Of these, 44.7% were
internists, 27.4% general practitioners (GPs), 11.9% surgeons, and 16.0% other specialists. Two hundred forty of physicians
(62%) routinely recommended colorectal cancer screening to asymptomatic, average-risk patients. Only 43% gave the
correct recommendation for the correct starting age. Colonoscopy (47.5%) and fecal occult blood test (40.0%) were preferred
by the majority of physicians, whereas fl exible sigmoidoscopy, double contrast barium enema, and CT colonoscopy were
chosen by 5.7%, 4.4%, and 1.8% of physicians respectively. Surgeons had more knowledge of test effi cacy and frequency.
They also were more aware of colorectal cancer screening than internists. Patient ignorance (66.1%), unavailability of the
test (64.6%), unawareness of physicians (57.9%), and fi nancial problems (41.1%) were determined as barriers for colorectal
cancer screening.
Conclusion : Although the majority of physicians are aware of colorectal cancer screening, the correct knowledge is lacking.
Colonoscopy and FOBT are their most preferred tests. Patient ignorance, unavailability of the test, unawareness of physician,
and fi nancial problems are the main barriers for colorectal cancer screening. Improvement in academic support services
and standard clinical practice guideline are needed to improve overall morbidity and mortality of colorectal cancer.
Keywords : Colorectal cancer screening, Primary care physicians, Awareness
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