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.
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References
WHO (2013). Cancer. Downloaded from http://www.who.int/mediacentre/factsheets/fs297/en/index.htmlon Nov 22nd, 2013
Al-Zahrani AN, Ravichandran K, Al-Madouj AN (2003) Cancer incidence among gulf cooperation council states’ nationals. Riyadh, Saudi Arabia 2008
Jemal A, Siegel R, Ward R, Murray T, Jiaquan Xu J, Thun M (2007) Cancer statistics. CA Cancer J Clin 57:43–66
Vir KR, Gill S, Yoshida E et al (2010) Racial differences in the incidence of colorectal cancer. Can J Gastroenterol 24:47–51
Dey S, Soliman AS (2010) Cancer in the global health era: opportunities for the Middle East and Asia. Asia Pac J Public Health 22(3):75S–82S
Ministry of Health of Jordan (MOH) – (2009) Cancer incidence in Jordan, report of 2008. Non-Communicable Diseases Control Section, Amman, Jordan
National Cancer Registry (NCR) (2009) Cancer incidence in Jordan report of 2008. Non-Communicable Diseases Control Section, Amman, Jordan
Umar A, Greenwald P (2009) Alarming colorectal cancer incidence trends: a case for early detection. Cancer Epidemiol Biomarkers Prev 18:1672–1673
Huxley RR, Ansary-Moghaddam AA, Clifton P, Czernichow S, Parr CL, Woodward M (2009) The impact of dietary and life style risks of colorectal cancer: a quantitative overview of the epidemiology evidence. Int J Cancer 125(1):171–180
Musaiger AO (2004) Overweight and obesity in the eastern Mediterranean Region: can we control it? East Mediterr Health J 10:789–793
Motlagh B, O’Donnel M, Yusuf S (2009) Prevalence of cardiovascular risk factors in the Middle East: a systematic review. Eur J Cardiovasc Prev Rehabil 16:268–280
Klabunde CN, Frame PS, Meadow A, Jones E, Nadel M, Vernon SW (2003) A national survey of primary care physicians’ colorectal cancer screening recommendation and practices. Prev Med 36:352–362
McFarland EG, Levin B, Lieberman DA, Pickhardt PJ, Johnson CD, Glick SN, Brooks D, Smith RA (2008) Revised colorectal cancer screening guidelines. Joint effort of the American Cancer Society, USA
National Comprehensive Cancer Network (2010). NCCN guidelines for patients. Downloaded from: http://www.nccn.org/patients/guidelines/colon/index.html#4
U.S. Preventive Services Task Force (2008) Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 149(9):627–637
Seef L, Nadel M, Klabunde C et al (2004) Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer 100(10):2093–2103
Greiner K, Engelman K, Hall M, Ellerbeck E (2004) Barriers to colorectal cancer screening in rural primary care. Prev Med 38(3):269–275
Young W, McGloin J, Zittleman L, West D, Westfall J (2007) Predictors of colorectal screening in rural Colorado: testing to prevent colon cancer in the High Plains Research Network. J Rural Health 23(3):238–245
Hannon PA, Martin DP, Harris JR, Bowen D (2008) Colorectal cancer screening practices of primary care physicians in Washington State. Cancer Control 15(2):174–181
Federici A, Rossi PG, Bartolozzi F, Farchi S, Borgia P, Guastcchi G (2005) Survey on colorectal cancer screening knowledge, attitudes and practices of general practice physicians in Lazio, Italy. Prev Med 41:30–35
Jo AM, Maxwell AE, Rick AJ, Cha J, Bastani R (2009) Why are Korean American physicians reluctant to recommend colorectal cancer screening to Korean American patients? Exploratory Interview findings. J Immigr Minor Health 11:302–309
Guerra CE, Schwartz JS, Armstrong K, Brown JS, Halbert CH, Shea JA (2007) Barriers and facilitators to physician recommendation of colorectal cancer screening. J Gen Intern Med 22(12):1681–1688
Boehler M, Advani V, Schwind C, Wietfeldt E, Becker Y, Lewis B, Rakinic J, Hassan I (2011) Knowledge and attitudes regarding colorectal cancer screening among medical students: a tale of two schools. J Cancer Educ 26:147–152
Garr DR, Lackland DT, Wilson DB (2000) Prevention education and evaluation in U.S. medical schools: a status report. Acad Med 75(7Suppl):S14–S21
Zapka JG, Luckmann R, Rulsky SI, Goins KV, Bigelow C, Mazor K, Quirk M (2000) Cancer control knowledge, attitudes, and perceived skills among medical students. J Cancer Educ 15(2):73–78
Ramos M, Esteva M, Almeda J, Cabeza E, Puente D, Salaich R, Boada A, LIagostera M (2010) Knowledge and attitudes of primary health care physicians and nurses with rgard to population screening for colorectal cancer in Balearic Islands and Barcelona. BMC Cancer 10(500):1–9
O’Malley AS, Beaton E, Yabroff KR, Abramson R, Mandelblatt J (2004) Patient and provider barriers to colorectal screening in the primary care safety net. Prev Med 39:56–63
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The authors thank the HCPs in primary care settings for participating in this study and Jordan University of Science and Technology for funding support for this study.
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The authors declare they have no conflict of interest.
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Omran, S., Barakat, H., Muliira, J.K. et al. Knowledge, Experiences, and Barriers to Colorectal Cancer Screening: A Survey of Health Care Providers Working in Primary Care Settings. J Canc Educ 30, 53–61 (2015). https://doi.org/10.1007/s13187-014-0676-0
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DOI: https://doi.org/10.1007/s13187-014-0676-0