Knowledge and practice of colorectal cancer screening in an urban setting : cross-sectional survey of primary care physicians in government clinics in Malaysia.

Ooi, Chor Yau and Nik Sherina, Binti Hanafi and Liew, Su May (2019) Knowledge and practice of colorectal cancer screening in an urban setting : cross-sectional survey of primary care physicians in government clinics in Malaysia. Singapore Medical Journal, 60 (11). pp. 1-22. ISSN 0037-5675

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Abstract

INTRODUCTION: Colorectal cancer (CRC) was the third most commonly diagnosed cancer worldwide in 2008 (1.23 million cases, 9.7%). CRC screening was shown to be effective in reducing 70% of CRC mortality. However, the screening rate for CRC remains poor. METHODS: A cross-sectional survey was conducted among primary care physicians (PCPs) in public primary care clinics in Kuala Lumpur, Malaysia. A 30-item self-administered questionnaire was used to assess the knowledge and practice of CRC screening. RESULTS: The response rate was 86.4% (n = 197/228). Less than half (39.1%) of respondents answered correctly for all risk stratification scenarios. Mean knowledge score on CRC screening modalities was 48.7% ± 17.7%. The knowledge score was positively associated with having postgraduate educational qualification and usage of screening guidelines. Overall, 69.9% of PCPs reported that they practised screening. However, of these, only 20.7% of PCPs screened over 50% of all eligible patients and only 5.2% of PCPs screened over 75% of all eligible patients. PCPs who agreed that screening was cost-effective (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.69-6.59) and those who agreed that they had adequate resources in their locality (OR 1.92, 95% CI 1.01-3.68) were more likely to practise screening. Knowledge score was not associated with the practice of screening (p = 0.185). CONCLUSION: Knowledge and practice of CRC screening was inadequate among PCPs. Knowledge of screening did not translate into its practice. PCPs' perceptions about cost-effectiveness of screening and adequate resources were important determinants of the practice of screening.

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