Cancer education among primary care physicians in an underserved community

Introduction: Urban minority groups, such as those living in north Manhatta n, are generally underserved with regard to cancer prevention and screening practices. Primary care physicians are in a critical position to counsel t heir patients on these subjects and to order screening tests for their pati ents. Methods: Eighty-four primary care physicians in two intervention communitie s who received educational visits about cancer screening and prevention wer e compared with 38 physicians in a nearby community who received no interve ntion. With pre- and post-test interviews over an 18-month period, the phys icians were asked about their attitudes toward, knowledge of (relative to A merican Cancer Society guidelines), and likelihood of counseling and screen ing for breast, cervical, colorectal, and prostate cancers. Results: Comparison of the two surveys of physicians indicated no statistic ally significant differences in knowledge of cancer prevention or screening . At post-test, however, intervention group physicians identified significa ntly fewer barriers to practice than control physicians (p < 0.05). While o verall, the educational visits to inner-city primary care physicians did no t appear to significantly alter cancer prevention practices, there was a po sitive dose-response relationship among the subgroup of participants who re ceived three or more project contacts. Conclusions: We uncovered significant changes in attitude due to academic d etailing among urban primary care physicians practicing in north Manhattan. A significant pre-test sensitization effect and small numbers may have mas ked overall changes in cancer prevention and screening behaviors among phys icians due to the intervention. (C) 2000 American Journal of Preventive Medicine.