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Cancer screening and prevention in primary care. Obstacles for physicians

R C Wender1

  • 1Department of Family Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania 19107.

Cancer
|August 1, 1993
PubMed
Summary

Primary care physicians know cancer screening guidelines but don't always recommend them due to practice barriers. Addressing provider, patient, and system obstacles is key to increasing cancer prevention and screening uptake.

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Area of Science:

  • Clinical Practice
  • Health Services Research
  • Preventive Medicine

Background:

  • Primary care physicians are aware of cancer screening and prevention guidelines.
  • Despite awareness, these services are under-recommended for many patients.
  • Practice barriers represent a significant impediment to guideline implementation.

Purpose of the Study:

  • To identify and categorize major obstacles hindering the broad implementation of cancer screening and prevention.
  • To synthesize existing literature and expert knowledge on practice barriers in oncology prevention.

Main Methods:

  • A comprehensive literature review was conducted.
  • Author's synthesis of reviewed literature was employed.
  • Obstacles were identified and categorized into major types.

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Main Results:

  • Three primary categories of obstacles were identified: provider-specific, patient-specific, and health care delivery system obstacles.
  • Provider-specific barriers include time constraints, competing health issues, lack of expertise, and insufficient feedback.
  • Barriers affecting major cancer site screening (breast, colon, cervix) and preventive counseling were detailed.

Conclusions:

  • Overcoming barriers requires focused efforts to equip providers with necessary skills and improved time management.
  • Implementation of effective reminder systems and innovative feedback/reward mechanisms is crucial.
  • Addressing practice barriers is essential for increasing cancer screening and prevention rates.