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

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... Mehr ...

Verfasser: Lucinda Bertels
Sientje van der Heijden
Maartje Hoogsteyns
Evelien Dekker
Kristel van Asselt
Henk van Weert
Bart Knottnerus
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: BJGP Open, Vol 3, Iss 1 (2019)
Verlag/Hrsg.: Royal College of General Practitioners
Schlagwörter: Primary Health Care / Family Practice / Colorectal Neoplasms / Early Detection of Cancer / Colorectal Cancer Screening / Qualitative Research / Medicine (General) / R5-920
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27404637
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.3399/bjgpopen18X101631

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.