This report describes the findings from qualitative interviews conducted with GPs who either had, or had not been involved in the English Bowel Screening Pilot. Therefore, it is also important to understand the specific information needs of general practitioners involved with bowel cancer screening. GPs could play a role in the facilitation of informed choice in patients who consult them about participating in bowel cancer screening, a task entirely dependant on the provision of relevant, accurate and complete information. Informed choice is a central strand to the BCSP, with the National Screening Committee advising that both the risks and benefits are made explicit to individuals invited to cancer screening. If GPs are to effectively provide information to patients with queries about the screening programme, it is important to explore their attitudes towards the BCSP. In healthcare systems outside the UK (where primary care is more directly involved with the screening process), GPs have been identified as the preferred source of information about bowel cancer and the person most influential in patient's decisions regarding testing, with GP motivation associated with uptake of screening. GPs may be an important source of information for patients who have queries about bowel cancer screening. Therefore, their involvement is likely to be concerned with administrative duties (such as dealing with letters and reports generated by the screening units) and providing information to patients who have queries about the screening process. Primary care will not have direct responsibility for the recruitment or delivery of the programme. GPs will also be notified of the participant's positive FOBt result. If a participant receives a positive FOBt result they will be offered an appointment with a specialist nurse to discuss the implications of this at a local screening centre. The National Health Service Bowel Cancer Screening Programme (BCSP) will be centrally organised in England, with call-recall services and testing and analysis of FOBt kits performed by five central screening hubs across the country. A national programme of screening is expected to be rolled out in 2006. Data from the first pilot round demonstrated that FOBt screening for colorectal cancer is feasible within the context of the NHS. Two pilot screening rounds, which commenced in 2000, were implemented in order to assess the viability of a national screening programme for bowel cancer being undertaken within the UK National Health Service. Evidence from randomized controlled trials has confirmed that screening for colorectal cancer using Faecal Occult Blood testing (FOBt) as the primary screening modality can significantly reduce colorectal cancer mortality. It is important that the information needs of GPs and other members of the primary care team are addressed prior to the roll-out of the programme so they are equipped to promote informed choice and provide support to patients who consult them with queries regarding screening.Ĭolorectal cancer is the second most common cause of cancer death in the UK. Nonetheless, GPs hold some significant reservations regarding the programme.
The study has found considerable GP support for the introduction of the new Bowel Cancer Screening Programme. A number of specific information needs were identified by GPs to enable them to provide a supportive role to participants in the programme. However, in many cases these concerns were not confirmed through GPs experiences with the pilot. GPs who had taken part in the pilot reported holding similar concerns prior to their involvement. A number of concerns were identified by GPs who had not taken part in the pilot programme, particularly relating to patient welfare, patient participation, and increased workload. GPs in the study were generally positive about the introduction of the Bowel Cancer Screening Programme. Interviews covered attitudes towards the introduction of the Bowel Cancer Screening Programme, expected or actual increases in workload, confidence in promoting informed choice, and preferences for receiving information about the programme. 18 of these had participated in the English Bowel Screening Pilot, and 14 had not. Methodsģ2 GPs participated in semi-structured telephone interviews. The aims of the study were to examine GPs' attitudes and information needs with regard to bowel cancer screening, with a view to developing an information pack for primary care teams that will be circulated prior to the introduction of the programme. General Practitioners are a potentially important point of contact for participants throughout the screening process. The National Health Service Bowel Cancer Screening Programme is to be introduced in England during 2006.
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