Family doctor intervention is crucial in the fight against Europe’s second biggest cancer killer

As healthcare professionals, commissioners and politicians from across Europe convened earlier this month for the third ‘European Colorectal Cancer Days’ meeting in Brno in the Czech Republic, one of the meeting’s supporters, United European Gastroenterology (UEG) is calling for increased intervention from primary care physicians to improve colorectal cancer (CRC) screening uptake rates across Europe.

CRC is currently estimated to claim the lives of 214,675¹ adults in Europe – equivalent to 1 death every 3 minutes – and is expected to affect 502,000 Europeans a year by 2020². 

CRC screening programmes are currently underused with the uptake throughout much of Europe falling way short of the 65% rate considered desirable by the European Commission.

With the annual incidence of Europe’s second most lethal cancer killer predicted to rise by 12% by 2020² UEG is raising awareness that screening saves lives and believes that family doctor intervention is key to preventing rising mortality.

“Family doctors play a crucial role in the prevention and early detection of colorectal cancer by raising the subject of screening with eligible adults and explaining the benefits of available screening options,” explains UEG President Professor Michael Farthing.

“Research has found that lack of recommendation by a family doctor is a key barrier to colorectal cancer screening uptake. By proactively broaching the subject of screening, general practitioners can overcome common fears and misconceptions as well as the embarrassment factor that so often prevents people talking about and participating in CRC screening.”

Colorectal cancer is extremely lethal in its advanced stages yet early detection can result in a 90-95% survival rate. Regular screening reduces the risk of dying from the disease by 20-30% using the Faecal Occult Blood Test (FOBT), 50% using flexible sigmoidoscopy and up to 65% using colonoscopy. Widely available across Europe, the FOBT is generally offered to men and women over the age of 50 via an invitation from their doctor or a national screening programme.

The involvement of family doctors in CRC screening in Europe varies. In some countries (Germany, France, the Czech Republic), family doctors actually perform FOB testing in their surgeries; in others, they are tasked with recruiting patients for colonoscopic screening (Poland); while in countries such as the UK and the Netherlands, family doctors are not directly involved in screening but instead are required to encourage patients to participate in national programmes and to advise on the importance of screening.

" It is very important in countries with active screening programmes in place that comprehensive colorectal cancer education and support for family doctors is available to help them put screening high on the agenda at a practice level. Motivated and well informed doctors will in turn mobilise patients, and the link between patient screening compliance and practitioner motivation is well documented,” explains Professor Farthing.

#screeningsaveslives

Which patient groups do/don’t participate in CRC screening?

• Research has found a higher participation rate of women in FOBT-based screening programmes across Europe than in men.³
• Age is also a factor. Italian research found that men and women aged 65 years or older were more likely to participate in screening than younger invitees.⁴
• Smokers have been found to have poor CRC screening adherence compared to non-smokers and former smokers.⁵
• Adherence to other screening programmes e.g. prostate cancer (men) and breast cancer (women) has been positively associated with CRC screening uptake.⁶
• Research in Spain found that fear of screening tests and embarrassment were the main barriers that contributed to low participation.⁷