Family physicians' beliefs about screening for colorectal cancer using the stool guaiac slide test

The stool guaiac slide test (SGST) is a relatively recent innovation in screening for colorectal cancer. The test detects occult blood in the stool that may indicate the presence of cancer. In recent years, the SGST has been widely promoted as a screening test to aid in the detection of colorectal cancer. However, data from public and mass screening programs indicate that many people are unaware of the test and that few have actually taken it. The findings from these studies suggest that many physicians may not be using the test in their medical practices. The literature on diffusion theory suggests that acceptance of an innovation is influenced by the potential adopter's perception of the innovation's relative advantages over those of the ideas it supersedes, its perceived complexity, and its compatibility with the existing values and practices of the receiver. This research examined these factors as they relate to use of the SGST among a sample of 131 family physicians in New York State. Eighty-two percent of these physicians reported that they provide guaiac slides to at least some of their patients to collect stool specimens at home. The test was reportedly more commonly used for older patients than for younger ones. The physicians' beliefs about the relative effectiveness of the test in detecting early-stage colorectal cancer, compared with the effectiveness of alternative screening tests, and their perceptions about patients' willingness and ability to do the test at home were found to be important factors distinguishing between physicians who said they used the test and physicians who did not. The findings from this study suggest that future efforts aimed at promoting the use o1 theSGST among primary care physicians should emphasize the relative merits of the test in comparison with those of alternative screening procedures, especially with regard to its effectiveness in detecting early stage cancers, its simplicity, and its acceptance by patients.