[Cancer screening by primary care physicians: a chart audit].

BACKGROUND

Cancer screening requires identification of individuals at high risk for cancer, mainly through an adequate family history, and documentation of dates and results of past screening examinations. By asking general practitioners (GPs) to audit their charts, we sought to encourage them to enhance chart quality and their involvement in colorectal, breast and cervical cancer screening.

METHODS

Chart audit of data on family cancer history and past screening examinations. Volunteer GPs, working in groups, self-audited the completeness of their charts of 20 (10 women, 10 men) consecutive patients not seen for the first time and aged 40-74 years for colorectal, breast and cervix cancer.

RESULTS

In all, 37 GPs participated, analyzing 736 charts. Family history of cancer was documented in half the charts. A fecal occult blood test was mentioned in 51.2%, with a date in 40.2%. Mammograms were mentioned in 62.7% of women's charts, but only 27.9% contained complete information (family history, date and result of mammogram documented). Similarly, 44.2% of women's charts mentioned pap smears but only 25.9% contained complete information. The rates of complete charts ranged from 0 to 100% and varied with cancer and GP.

CONCLUSION

Quality of charts in primary care is globally poor but very heterogeneous, ranging from bad to excellent according to GP. The collection of updated information on family history and past screening examinations must be improved in primary care.