Primary care physicians' knowledge, attitudes and practices related to cancer screening and cancer prevention clinical trials.

Native Hawaiians have high cancer incidence and mortality rates, thus would benefit from timely cancer screening and opportunities to participate in cancer prevention clinical trials. Two-hundred-fifty-four (254) primary care physicians (PCPs) were surveyed for their knowledge, attitudes, and practices related to cancer screening and prevention, clinical trials and participation of Native Hawaiians in them. More than 90% of responding PCPs follow guidelines for breast and cervical cancer screening and counsel patients on smoking cessation, and 75% or greater follow guidelines for colonoscopy/sigmoidoscopy testing and counsel patients on exercise, diet, and weight management. About 60% reported familiarity with at least one of three prevention trials offered at the time of the survey, and 28% reported having referred or recommended patients to cancer prevention trials in the past. Major barriers to discussing trials with patients included lack of awareness on the part of physicians and patients, limited support staff, and time constraints. Less than 30% of respondents were aware of community resources supporting cancer research. This study indicated that Hawai'i PCPs follow national guidelines for cancer screening, and many are aware of ongoing prevention trials. However, additional participation in cancer screening and prevention activities will require attention to reducing logistical barriers and increasing awareness of cancer information and research services.