Cancer control knowledge and priorities among primary care physicians

Primary care physicians can play a key role in prevention and early detection of cancer. To assess cancer control knowledge and priorities among primary care physicians in Missouri, we conducted a random survey of 207 physicians. Although reported knowledge of the role tobacco plays in cancer causation was high, activity in tobacco cessation counselling and referral was low. Respondents considered diet to be a relatively unimportant factor in cancer causation, whereas they viewed sun exposure, genetics/family history, and radiation exposure as large contributors to the cancer burden. Among cancer early detection tests, high activity was shown for the Pap test and breast examination. Conversely, low activity was reported for colon sigmoidoscopy. Inverse correlations were shown between age group of the physician and several cancer prevention and early detection practices. For each cancer prevention and screening practice, reported activity was higher for medical doctors than for doctors of osteopathic medicine. Possible barriers or controversies in cancer control included disagreement with the current recommendation for Pap testing, the cost of mammography, and patient fear of sigmoidoscopy. These findings suggest that primary care physicians are not achieving their full potential in cancer control and indicate areas where increased emphasis is warranted.