Cancer screening guideline preference surveys: physicians' perceptions of the American Cancer Society.

OBJECTIVE The primary objective of this study was to assess cancer screening guideline preference by Tennessee internists and family physicians. DESIGN A one-page, 14-item survey was mailed to 580 internists and family physicians followed by a reminder postcard and a second survey within six weeks of the original mailing. The survey addressed physician practice characteristics, specific preferred cancer screening guidelines used, and self-evaluation of cancer screening and detection practices compared with the practice of coronary artery disease risk and prevention, depression, and obesity/adult-onset diabetes mellitus. SETTING Internal medicine and family physicians in Tennessee. RESULTS The overall survey response rate was 57% (N = 300). Of respondents, 83.4% were male and 16.6% were female. Eighty-three percent were board-certified, 30% had subspecialty training, and 62% practiced in a solo practice or a single-specialty group. There were few differences in guideline preference between generalists and subspecialists. Approximately 52% of respondents cited American Cancer Society (ACS) guidelines, 1.7% used US Preventive Services Task Force (USPSTF) guidelines, 34% cited a compilation of various guidelines, and 10% used no guidelines. More physicians rated their treatment of depression (22.9%) or obesity/diabetes mellitus (22.0%) as poor or needing improvement than rated their screening of cancer (16.3%) and coronary artery disease (12.5%) as poor or needing improvement. Survey respondents suggested that the ACS could be most effective in lobbying against tobacco and in providing patient education pamphlets. CONCLUSIONS Most physicians report using ACS screening guidelines, rate their cancer screening practices as good or very good, and recommend that the ACS lobby against tobacco and provide patient pamphlets. This study reflects physician preference of various cancer screening guidelines. Further research is needed to determine factors influencing physician preferred guideline use as well as actual practices.