Colorectal cancer screening in general practice. A survey of current practice and attitudes in Victoria.

OBJECTIVE: To determine the views and practices of Victorian general practitioners (GPs) on the early detection of colorectal cancer (CRC). METHODS: A 1995/1996 quantitative mail survey was used to determine GP knowledge and practice in relation to CRC screening and diagnosis in asymptomatic and symptomatic patients. This includes the amount of investigation, the type and process of diagnostic testing and attitudes to CRC screening. RESULTS: GPs are investigating symptomatic patients but few asymptomatic patients. In general, only patients in the increased risk groups are being investigated. Colonoscopy is the most common method of examination. Most GPs prefer faecal occult blood tests (FOBTs) to be interpreted via laboratory and endoscope procedures to be performed by a specialist. CONCLUSION: GPs were unlikely to screen asymptomatic patients unless there is a family or personal history of CRC or adenomatous polyps. Colonoscopy is the preferred practice for examining such patients. The use of FOBTs for screening standard risk asymptomatic patients was lower than recent research recommends. If population screening for CRC is endorsed, professional and public education in CRC tests, particularly for asymptomatic standard risk patients would be required. Patient initiated screening was highly favoured, supporting the need for public awareness programs.