RISK PREVALENCE AND SCREENING FOR CANCER BY GENERAL-PRACTITIONERS

Background. This study presents cancer risk prevalence and screening rates of patients attending general practitioners. Conditions addressed include smoking, skin cancer, Pap smears, clinical breast examinations, and mammography. Methods. A cross-sectional study of 7,160 patients 18-75 years presenting to 230 general practitioners in a metropolitan and country region in Queensland, Australia, was used. Risk prevalence was assessed from patients' self-report of risk behaviors and screening prior to the consultation. Details of preventive care provided in the consultation were based on doctors' self-report at the conclusion of the consultation. Results. Twenty-seven percent of men and 23% of women smoked, rates being highest in the younger age groups. Using national guidelines, prior screening had not occurred as recommended for men and women as follows: skin cancer screening - 66% of men, 70% of women; cervical cancer screening - 27%; clinical breast examination - 45%; mammography - 75%. These patients were thus categorized as ''at risk,'' and screening rates for these patients in the consultation were as follows: smokers - 34%; skin cancer - 5%; cervical cancer - 16%; mammography - 4%; clinical breast examination - 8%. Conclusions. Significant numbers of patients presenting to general practitioners were at risk of developing cancer, according to national guidelines. Of these, only small proportions of all groups had a preventive intervention by their GP at the consultation identified in this study. While GPs generally see their role in prevention as important, these results raise questions for future cancer prevention policies and training of GPs. (C) 1994 Academic Press, Inc.