Colorectal Cancer Screening Recommendations by Primary Care Physicians' in Seoul

Background: Regular colorectal cancer (CRC) screening is known to reduce the CRC incidence and mortality. Health care providers can play a key role in recommending screening to healthy people. However, data on providers' CRC screening knowledge, attitude, and practice are sparse in Korea. We investigated primary care physicians' perception and performance of practice guidelines for CRC screening recommendations, and their view of barriers to physicians' adherence to guidelines. Methods: A questionnaire was administered to 760 primary care physicians of internal medicine, general surgery, and family medicine in Seoul, Korea. The data were collected from March 2 to April 30, 2004, and those of 106 respondents (response rate 14%) were analyzed. Results: Forty seven percent of respondents reported they recommended CRC screening. The most common screening test equipment in primary care settings was the fecal occults blood test (22.6%) followed by sigmoidoscopy (16.0%), colonoscopy (16.0%), and double contrast barium enema (10.4%). However, colonoscopy was recommended the most as a CRC screening method (54%) and only 43% of respondents complied with the interval indicated on the guidelines. Awareness (64.8%) and agreement (93.2%) to CRC screening recommendation by primary care physicians in Seoul, Korea was high, but the screening delivery was suboptimal. Many primary care physicians regarded patient-related factors were more important barriers of CRC screening than environment-related factors. Conclusion: There were many barriers to physicians' guideline adherence. It may be useful to develop and improve guidelines in considerationt these barriers to establish appropriate cancer screening.