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      Colorectal cancer screening practise is influenced by ethnicity of medical practitioner and patient.

      Journal of Gastroenterology and Hepatology
      Adult, Attitude of Health Personnel, ethnology, Australia, epidemiology, Chi-Square Distribution, Colonoscopy, Colorectal Neoplasms, diagnosis, Cultural Characteristics, Emigrants and Immigrants, statistics & numerical data, Ethnic Groups, Female, General Practitioners, Guideline Adherence, Health Knowledge, Attitudes, Practice, Health Services Accessibility, Healthcare Disparities, Humans, Incidence, Male, Mass Screening, methods, Middle Aged, Occult Blood, Patient Acceptance of Health Care, Patients, Physician's Practice Patterns, Practice Guidelines as Topic, Predictive Value of Tests, Questionnaires

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          Abstract

          Colorectal cancer (CRC) screening improves survival and requires appropriate recommendation by general practitioners (GPs). Screening practises may be influenced by barriers related to ethnicity and training. A mail survey assessed GPs' practises and the barriers towards CRC screening. The association of screening practises and demography, including GP ethnicity, medical training and practise characteristics, were evaluated. Of 212 GPs (median age 54 years, 73% men, 27% Caucasian, 38% foreign graduates), 87% agreed that fecal occult blood test (FOBT) screening improved survival in the average-risk patient. Considerable variations existed in the starting age (40-49 years: 31%; 50 years: 65%) and frequency (1-2 years: 77%; 3-5 years: 22%) of screening. FOBT was used for indications other than screening: anemia (59%), altered bowel habits (54%), abdominal pain (24%), and rectal bleeding (23%), and these were significantly more frequent in Asian GPs independent of medical training. GPs were less likely to recommend screening to immigrants, and most reported that immigrants were less likely to participate. More Asian and Middle Eastern GPs reported a major barrier with FOBT inaccuracy compared with Caucasian GPs (22% vs 9%, P = 0.03; and 27% vs 9%, P = 0.03, respectively). Considerable differences existed in GPs' CRC screening practises. Indications for use of FOBT and the subsequent investigation of a positive FOBT also varied according to GPs' ethnicity, independent of medical training. Patient's ethnicity and associated language and cultural barriers may affect screening uptake, which may negatively affect the health of immigrants. Resources and culture-specific interventions are recommended to improve overall screening participation. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

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