Abstract：
OBJECTIVE: This study aims to identify the factors influencing colorectal cancer (CRC) screening practices, along with the barriers and facilitators from the perspective of primary care physicians (PCPs) in Ukraine. Considering health care system challenges, including those posed by the ongoing war, this research seeks to inform improvements in CRC screening and outcomes in Ukraine and other low- and middle-income countries (LMICs).
METHODS: A survey was designed and distributed electronically to Ukrainian PCPs, focusing on CRC screening practices, beliefs, and barriers. The survey incorporated questions adapted from established cancer screening surveys and frameworks. Complete responses were collected from 740 PCPs. Sample statistics were computed, and population-level perceptions and associations with CRC screening practices were estimated by standardizing responses to national PCP demographics.
RESULTS: The majority of respondents were women (91%) and specialized in family medicine (84%). Respondents believed in the effectiveness of colonoscopy for reducing CRC mortality (80%), with 75% of PCPs referring patients for this screening modality. Major barriers identified include inadequate training of PCPs in screening and lack of resources. Respondents reported high utilization of fecal occult blood test and colonoscopy for screening when these tests were said to be available in their practices. Self-reported familiarity with CRC screening guidelines and participation in educational workshops were positively associated with screening referrals.
CONCLUSIONS: The study highlights the role of access to CRC screening tests and awareness of screening guidelines in enhancing CRC screening practices among Ukrainian PCPs. Addressing training and resource barriers, alongside public health interventions targeting patient-related barriers, is essential. These findings offer valuable insights for LMICs facing similar challenges, emphasizing the need for tailored strategies to improve cancer screening in these health care settings.
METHODS: A survey was designed and distributed electronically to Ukrainian PCPs, focusing on CRC screening practices, beliefs, and barriers. The survey incorporated questions adapted from established cancer screening surveys and frameworks. Complete responses were collected from 740 PCPs. Sample statistics were computed, and population-level perceptions and associations with CRC screening practices were estimated by standardizing responses to national PCP demographics.
RESULTS: The majority of respondents were women (91%) and specialized in family medicine (84%). Respondents believed in the effectiveness of colonoscopy for reducing CRC mortality (80%), with 75% of PCPs referring patients for this screening modality. Major barriers identified include inadequate training of PCPs in screening and lack of resources. Respondents reported high utilization of fecal occult blood test and colonoscopy for screening when these tests were said to be available in their practices. Self-reported familiarity with CRC screening guidelines and participation in educational workshops were positively associated with screening referrals.
CONCLUSIONS: The study highlights the role of access to CRC screening tests and awareness of screening guidelines in enhancing CRC screening practices among Ukrainian PCPs. Addressing training and resource barriers, alongside public health interventions targeting patient-related barriers, is essential. These findings offer valuable insights for LMICs facing similar challenges, emphasizing the need for tailored strategies to improve cancer screening in these health care settings.
摘要：
目的：本研究旨在确定影响结直肠癌（CRC）筛查实践的因素，以及乌克兰初级保健医生(PCP)的障碍和促进者。考虑到医疗保健系统的挑战，包括那些正在进行的战争所造成的，这项研究旨在为乌克兰和其他低收入和中等收入国家(LMICs)的CRC筛查和结局的改善提供信息.
方法：设计了一项调查，并以电子方式分发给乌克兰PCP，侧重于CRC筛查做法，信仰,和障碍。该调查纳入了根据已建立的癌症筛查调查和框架改编的问题。从740个PCP中收集完全应答。计算了样本统计数据，通过对国家PCP人口统计数据的标准化反应，估计了人口层面的看法和与CRC筛查实践的关联。
结果：大多数调查对象是女性（91%）和家庭医学专业（84%）。受访者认为结肠镜检查可降低CRC死亡率（80％）。75%的PCP将患者推荐为这种筛查方式。确定的主要障碍包括对PCP进行筛查培训不足和缺乏资源。受访者报告说，当这些测试在他们的实践中可用时，粪便潜血测试和结肠镜检查用于筛查的利用率很高。自我报告对CRC筛查指南的熟悉程度和参加教育研讨会与筛查转诊呈正相关。
结论：该研究强调了获得CRC筛查测试和对筛查指南的认识在加强乌克兰PCP中CRC筛查实践中的作用。解决培训和资源障碍，除了针对患者相关障碍的公共卫生干预措施，是必不可少的。这些发现为面临类似挑战的低收入国家提供了有价值的见解，强调需要量身定制的策略来改善这些医疗保健环境中的癌症筛查。
方法：设计了一项调查，并以电子方式分发给乌克兰PCP，侧重于CRC筛查做法，信仰,和障碍。该调查纳入了根据已建立的癌症筛查调查和框架改编的问题。从740个PCP中收集完全应答。计算了样本统计数据，通过对国家PCP人口统计数据的标准化反应，估计了人口层面的看法和与CRC筛查实践的关联。
结果：大多数调查对象是女性（91%）和家庭医学专业（84%）。受访者认为结肠镜检查可降低CRC死亡率（80％）。75%的PCP将患者推荐为这种筛查方式。确定的主要障碍包括对PCP进行筛查培训不足和缺乏资源。受访者报告说，当这些测试在他们的实践中可用时，粪便潜血测试和结肠镜检查用于筛查的利用率很高。自我报告对CRC筛查指南的熟悉程度和参加教育研讨会与筛查转诊呈正相关。
结论：该研究强调了获得CRC筛查测试和对筛查指南的认识在加强乌克兰PCP中CRC筛查实践中的作用。解决培训和资源障碍，除了针对患者相关障碍的公共卫生干预措施，是必不可少的。这些发现为面临类似挑战的低收入国家提供了有价值的见解，强调需要量身定制的策略来改善这些医疗保健环境中的癌症筛查。
