Colorectal Cancer: Knowledge and Attitudes of Doctors in Victoria

Colorectal cancer: knowledge and attitudes of doctors in Victoria. F. A. Macrae, D. J. Hill, O. Dent, K. J. Goulston and D. J. B. St. John, Aust. N.Z. J. Med., 1982, 12, pp. 278–283. 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 one in five 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 first‐degree relatives of patients with colorectal cancer and only 10% recognised the similar increase in risk for people with a history of resected colorectal cancer. While 73% of doctors order faecal occult blood tests, only 9% were aware that the more reliable guaiac method was used for their patients. Overall , 38% considered that faecal 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 barium enema (75%), but only 58% would want sigmoidoscopy performed and 34% colonoscopy. The diagnostic potential of digital rectal examination and sigmoidoscopy was over‐estimated by half of the doctors surveyed. Recognition of subjects at high risk for colorectal cancer, and know ledge about the proper use, follow‐up, and potential for screening of faecal occult blood tests need emphasis in medical educational programmes.