Health belief and compliance with screening for fecal occult blood.

Additional data regarding compliance with screening for occult bowel neoplasm using hemoccult II is reported in this paper. The effects of 'health beliefs' and 'barriers to compliance' among a subset of 256 compliers and 166 noncompliers drawn from the population of 5003 patients previously screened were analyzed. Health belief variables as predictors of compliance were found to be age related. Being 'too busy' was frequently given as the reason for noncompliance in all age groups. The percentage of patients correctly classifies as to compliance was appreciably higher than in the earlier study which considered demographic data and the effect of diet restriction. These findings carry implications extending into clinical practice.

Patient compliance with screening for fecal occult blood in family practice.

Thirty-two family physicians in British Columbia collaborated in a study to evaluate their patients' compliance when offered testing for fecal occult blood (FOB) with Hemoccult II as a screening test for asymptomatic colorectal cancer. Of the 5003 eligible patients 71% complied. Thirteen variables were investigated. Compliance was found to be directly related to age in a linear manner (chi-squared value for trend = 180.4, p less than 0.0001), age alone correctly classifying 58.5% of the patients as complying or not complying. The association with other variables was less strong. Restricting the consumption of red meat during the test period had no effect on compliance.

Occult blood testing for early detection of colorectal cancer: diagnostic outcomes.

Three thousand five hundred and fifty-four asymptomatic persons from 32 family practices returned hemoccult II tests for colorectal cancer; 2.2% of these returned tests were positive. The diagnoses for the 47 persons with positive tests which were done while on meat restriction included six cancers (1.7/1000) and five polyps (1.4/1000); 18 were diagnosed with other known sources, and 18 were undiagnosed. All polyps and four of six cancers were diagnosed by combined barium enema with sigmoidoscopy or by colonoscopy. Five of six cancers were diagnosed at early stages. Meat restriction, the method of returning the test for analysis, the number of holes completed in the test, and the delay time from completing the test to analysis did not influence the likelihood of a positive test.

How representative are volunteer physicians in collaborative research projects?

Few family physicians can generate large samples for statistically significant research, which has led to multicentre collaborative studies. Are the volunteers for these studies typical of family physicians as a whole? If they are not, results will be biased. This preliminary study examines the differences between a group of volunteers and non-volunteers, using several variables. The only statistically significant difference was in place of practice: volunteers were far more likely to come from small towns than from metropolitan or rural areas. Discriminate analysis showed it was possible to predict correctly to which group the physician belonged in only 62% of cases. Further study must be done on other potentially sensitive variables.