Survey of surgeons' and internists' knowledge of colorectal cancer screening

Colorectal cancer (CRC) is the most common of the gastrointestinal cancers in Israel, with an incidence of 50 cases per 100,000 for men and 45 per 100,000 for women in 2000.

The low rate of patient compliance noted in CRC screening program conducted in our center, prompted the present survey of the knowledge and practices regarding CRC screening recommendations.

A 23-item questionnaire formulated according to the Israeli Ministry of Health policy and recommendation of the American Gastroenterological Association was distributed among the physicians of the six departments of internal medicine, and the department of surgery of the Rabin Medical Center. The relative ratio of correct answers was calculated for every question and by subgroups: internists and surgeons, experts and residents in internal medicine and in surgery.

Fifty-five of 80 physicians (69%) completed the questionnaire. The total score for all participants was 15.82 (average 0.68), significantly lower than the optimal correct score of 23 (average 1.00). The internists had a similar total score to the surgeons, 15.61 and 15.28. When the questions were clustered according to specific issues and only the correct answers for each cluster scored, the success rate decreased with a range of 19-69%. Only 22% of responders did not advise fecal occult blood test (FOBT) for the high-risk population; 57% thought the screening age range was 40-65 years, and only 37% knew that the high-risk criteria include a family history of ovarian cancer.

Both internists and surgeons' knowledge about screening recommendations of CRC can be improved. Health authorities should invest greater efforts in continuing physician education. We believe that this strategy will increase the participation rate in CRC preventive programs.