Publications (2)0.8 Total impact
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Article: Evaluation of French guidelines on the indications of colonoscopy: results of a regional practice survey.
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ABSTRACT: Compliance with guidelines on colonoscopic indications can improve colorectal cancer screening efficiency. We conducted a regional practice survey of gastroenterologists working in the public and private sectors in France, and compared the results with French national guidelines. Four consecutive yearly questionnaire-based practice surveys were conducted, and remedial measures were recommended on the basis of the results. We analyzed 5128 colonoscopies carried out by 65 practitioners. Of these, 4266 (83.2%) conformed to contemporary guidelines, 391 (7.6%) did not conform, and 471 (9.2%) could not be classified, owing to a lack of information. Remedial measures led to a significant increase in the number of colonoscopies conforming to guidelines (p=0.037) and to a significant fall in the number of unclassified procedures (p=0.0018). The distribution of colonic lesions differed between procedures that did and did not conform to guidelines (2.4% versus 0.3% of colorectal cancers, 11.4% vs. 6.9% of advanced adenomas, and 17.5% vs. 14.6% of non-advanced adenomas; p<0.0001). This longitudinal multicenter survey shows that national colonoscopy guidelines are largely respected in France and improve the detection of colonic neoplasia. Practices improved following implementation of remedial measures.Gastroentérologie Clinique et Biologique 09/2011; 35(12):839-44. · 0.80 Impact Factor -
Article: General practitioner and specialist views on colonoscopic screening of first-degree relatives of colorectal cancer patients.
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ABSTRACT: Barriers to targeted colonoscopic screening of first-degree relatives of colorectal cancer patients have been the subject of considerable literature, always as seen from the patient's viewpoint. In the specific context of screening individuals with a family history, physicians may also play a predominant role in motivating their colorectal cancer patients to pass on screening information to their relatives. The aim of this study was to examine the views of general practitioners and specialists regarding barriers and facilitators affecting participation of relatives in colonoscopic screening. A qualitative study was conducted to collect and analyse information from two focus groups of 4 general practitioners and 9 gastroenterologists respectively, and from semi-structured individual interviews with 10 general practitioners, 2 surgeons and 3 oncologists. An extended focus group of 36 gastroenterologists was organized to validate the results. The main barriers to colonoscopic screening of FDRs were associated with lack of direct communication between physicians and FDRs. Physicians needed support in the task of informing index patients and persuading them to transfer information on screening to their FDRs. The general practitioners spoke of their expectations in terms of training in and motivation for promoting screening and the gastroenterologists expressed the wish for patient education material specific to colonoscopy and for systematic post-colonoscopy consultations to inform patients about their results, follow-up and screening their relatives. The findings, notably the need for specific education materials and for training to improve the motivation of physicians, will help to develop effective interventions intended to increase participation in screening.Cancer epidemiology. 09/2009; 33(3-4):223-30.
