Colorectal Cancer: Knowledge and Attitudes of Doctors in Victoria

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Abstract
Successful introduction of screening for early colorectal cancer will depend, at least in part, on doctors'' knowledge and attitudes. A 34 item questionnaire was sent to a random sample of 1 in 5 doctors in Victoria, with a final completion rate of 65%. The survey revealed gaps of knowledge, particularly about recognition of high-risk groups. Only 12% were aware of the degree of increased risk faced by 1st-degree relatives of patients with colorectal cancer and only 10% recognized the similar increase in risk for people with a history of resected colorectal cancer. While 73% of doctors order fecal occult blood tests, only 9% were aware that the more reliable guaiac method was used for their patients. Overall, 38% considered that fecal occult blood testing was a practical method for screening for colorectal cancer. Most of the doctors who accepted occult blood screening would follow up a positive test with digital rectal examination (80%) and Ba enema (75%), but only 58% would want sigmoidoscopy performed and 34% colonoscopy. The diagnostic potential of digital rectal examination and sigmoidoscopy was overestimated by half of the doctors surveyed. Recognition of subjects at high risk for colorectal cancer and knowledge about the proper use, follow-up and potential for screening of fecal occult blood tests need emphasis in medical educational programs.