Abstract B29: GP’s attitudes towards cancer screening: Does gender still matter?

Abstract

Abstract B29 Background Cancer screening is expected to play a significant part in cancer control. However, individual’s participation, in some instances, may become the weakest link in the chain designed to decrease cancer-related mortality. Many factors are at stake when looking at participation rates. They include individual factors (psychological, cultural, income, priorities in life), societal factors (rules and level for insurance coverage, investment in health) as well as organizational factors (mass screening, systematic invitation and accessibility). In addition, characteristics of primary care providers have been associated with rates of participation in many preventive health services, including cancer screening. Our survey aims at investigating GP’s characteristics in relation to cancer screening, in their daily practice. Materials and Methods A nationwide observational survey (EDIFICE) was conducted, by telephone from December 2007 to January 2008, on a representative sample of 600 GPs practicing in France. Statistical comparisons were carried out by the Student's t test for quantitative data, and by the Z test and the Chi-square test for comparing percentages and numbers, respectively, in the case of categorical data. Differences were considered statistically significant when the probability value was less than 0.05 (bilateral test). Multivariate logistic regression analyses were expressed in terms of the odd ratio (OR) and 95% CI and performed using the SAS® software, version 8.2 (proc FREQ and proc LOGISTIC procedures). Results For breast cancer screening, systematic recommendation is associated with the GP’s gender (female OR=1.9 (1.2-3.1)) and with systematic recommendation for colorectal cancer OR=1,5 (1,0-2,5), and for prostate cancer OR 2,7 (1,8-4,1). In addition, GP’s motivation increases systematic recommendation. For colorectal cancer screening, the GP’s gender has no significant impact, but systematic recommendation for both breast and prostate cancer screenings has a positive impact OR= OR= 2.7 (1.6-4.7) and OR= 1.8 (1.1-3.0) respectively. Being well informed about screening and living in an area with a long-standing implemented program, also increases the rate of systematic recommendation; OR= 2.4 (1.4-4.0) and OR= 2.4 (1.3-4.3) respectively. For prostate cancer screening, GP’s gender also has no significant impact, while systematic recommendation for both breast and colorectal cancer screening has an impact; OR= 2.9 (2.0-4,4) and OR=2.0 (1.3-3.2) respectively. Belief that prostate cancer screening decreases cancer specific mortality is, for prostate cancer, associated with a higher rate of systematic recommendation OR= 2.0 (1.3-2.9). The age of the GP is not associated with a higher rate of systematic recommendation for screening any of the three types of cancer. Comments and Conclusions There is a global pattern of physicians being screening-prone (as suggested by the cross impact of a recommendation for one organ to another). However, there are also individual characteristics such as gender, since being a female GP increases systematic recommendation for breast cancer screening, whereas being a male GP does not increase systematic recommendation for prostate cancer. Factors associated with systematic recommendation should be both, a concern and a target for action, in order to improve individual’s adherence through GP’s commitment. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B29.