gms | German Medical Science

Background: General practitioners perform, give advise on and refer patients to cancer screening examinations. Their behavior might be influenced by their attitude.

Aim of study: Aim of this study was to assess German general practitioners’ attitudes towards colonoscopy, occult blood test, skin cancer screening, digital-rectal investigation, PSA screening, mammography, breast palpation by a physician and cervical cancer screening as cancer screening examinations.

Methods: 500 German general practitioners were asked to participate in a survey on their attitudes towards eight cancer screening examinations. They rated how reasonable they regard the respective examination on a scale of 1 to 4 (1=not reasonable to 4=reasonable) in general and in vulnerable sub-populations. Furthermore, general practitioners indicated whether they deem problematic aspects relevant for the particular examinations.

Results: The 136 participating general practitioners were 66% male, had a mean age of 55 ± 9 years and a mean working experience as general practitioners of 21 ± 9 years. 47% worked in a group practice and 52% in a single practice. General practitioners rated all examinations to be reasonable with colonoscopy reaching highest and PSA screening lowest values. Screening was rated to be more reasonable for people with positive family history and – except for skin cancer screening – less reasonable for people aged 80 or older. General practitioners feel responsible for recommending most and carrying out several of the investigated screening examinations. A lack of evidence was indicated by 41%, 37% and 29% of general practitioners for occult blood test, PSA screening and digital-rectal investigation. Furthermore, 38% and 23% general practitioners perceive busy schedules of specialists to be problematic especially for colonoscopy and skin cancer screening. Psychological and / or physical burden for the patient through the examination itself or false-positive results is indicated for several of the enclosed investigations.

Discussion: General practitioners are generally positive about cancer screening and consider risk factors and patients’ age in their perception of how reasonable examinations are.

Practical implications: General practitioners have contact to a great part of the screening-relevant population. They perceive to be actively involved in recommending and carrying out cancer screening examinations and their perceptions of access barriers and other critical aspects should thus be taken into consideration.