Attitudes toward performance of endoscopic colon cancer screening by family physicians

Background and Objectives: This study's purpose was to examine attitudes of family physicians and gastroenterologists toward family physician performance of lower endoscopy in general practice. Methods: A mailed survey was sent to 1,563 board-certified physicians in Georgia (1,303 family physicians, 260 gastroenterologists). Respondents were asked to describe their practice of lower endoscopy procedures and colorectal (CRC) screening preferences. Results: Fifty-one percent (801) of the surveys were returned. For CRC screening, family physicians recommend fecal occult blood testing most frequently (51.7%), while gastroenterologists recommended colonoscopy most frequently (89.5%). Most family physicians believe that family physicians should perform flexible sigmoidoscopy (FS) (81.4%) and colonoscopy (CS) (71.3%). A total of 71.2% of surveyed gastroenterologists believe that family physicians should perform FS, but only a minority (4.5%) believe that family physicians should perform screening CSs. Approximately 28% (186) of family physicians report performing FS (mean=.8 FS per month). Only 3.7 % (25) of family physicians reported performing CS (mean=8.2 CSs per month). Conclusions: Although most family physicians believe that they should perform lower endoscopy, only a minority of gastroenterologists believe family physicians should perform CS. Our results show that family physician performance of lower endoscopic CRC screening is limited in general practice. Future research might consider exploring these issues from both the gastroenterologist and family physician perspective.