Colorectal cancer screening and surveillance: A survey among Thai general surgeons

Abstract

Purpose: A significant reduction in colorectal cancer (CRC) mortality is attributed to CRC screening and surveillance. However, there is no national consensus on CRC screening and surveillance in Thailand. The aim of this study was to assess current practice in CRC screening and surveillance among Thai general surgeons. Methods: Between July and November 2008, a questionnaire was randomly sent to general surgeons nationwide, mainly to those who worked in the General Province Hospital or University Hospital. Their responses were analyzed. Results: One hundred and twelve general surgeons completed questionnaires (56% response rate); about 39% of them were colorectal surgeons. Ninety-four surgeons (84%) routinely offered CRC screening to an asymptomatic, average-risk population. Most surgeons started CRC screening in an average-risk patient at the age of 50 years and did no screening in populations with age above 80 years. Colonoscopy is the most popular investigation used in CRC screening, followed by fecal occult blood testing and double contrast barium enema. When the surgeons themselves were subjected to CRC screening, colonoscopy was also the favorite investigation used. About 3-18% of surgeons showed interest in CRC screening with computed tomographic colonography. After curative CRC resection, most surgeons set up a surveillance program with examinations every 3 months in the first 2 years and performed post-CRC resection surveillance by colonoscopy at 1 year. Conclusions: There is a wide variation in CRC screening and surveillance among Thai surgeons. These results highlight the need to establish evidence-based and cost-effective CRC screening and surveillance in Thailand.