General Practitioners’ attitudes and beliefs on barriers to colorectal cancer screening: A qualitative study

Abstract

INTRODUCTION Colorectal cancer (CRC) is the third most frequent malignancy worldwide and causes millions of deaths every year. It is well known that more than 80% of colorectal cancers arise from adenomatous polyps, so screening for this cancer is effective for both early detection and prevention. Nevertheless, low rates of compliance are observed with the CRC screening recommendations. This study investigates the views and perceptions of General Practitioners (GPs) about CRC screening in Greece. METHODS We conducted semi-structured interviews with 32 GPs recruited from Central and Northern Greece. The interview guide addressed perceptions and barriers to colorectal cancer screening. Data collection took place between March 2019 and January 2020 and analyzed using Thematic Analysis. RESULTS GPs have a positive attitude toward CRC screening and try to exploit their opportunity during consultations to advise their patients about it. They face many barriers in their efforts to promote CRC screening. The most important of these are patients refusing for various reasons, lack of structures in the healthcare system or difficulties in approaching them, the cost of colonoscopy in the private sector, and concerns about the preparation or the process of the examination. CONCLUSIONS This study highlights the structural changes that are needed in the healthcare system, but also in the awareness of citizens and health professionals, in order to increase compliance with CRC screening.