Purpose: To investigate the attitudes and willingness of the general practitioners (GPs) as well as their actual participation in the voluntary colorectal cancer (CRC) screening campaign without additional financial incentives for them, combining quantitative and qualitative approaches.
Methods: A multiple-case practice based study was designed using a mixed method, triangulation techniques and a sequential explanatory design strategy. The study included all 41 GPs practices in the Municipality of Asenovgrad. A questionnaire, face-to-face semi-structured interviews, nonparticipant direct structured observations and documentation review were used to collect data. Variation analysis, alternative analysis for percentage calculation and Mann-Whitney U test to compare two independent groups and Fisher's Exact Test were used. Statistical significance of the null hypothesis was assumed at p<0.05.
Results: Older GPs (p=0.015) and those working with a practice nurse (p=0.000) were more inclined to participate in the CRC screening campaign. GPs more knowledgeable of the importance of CRC screening with iFOBT (immunochemical faecal occult blood test), (p=0.002) and those trusting its quality (p=0.007) were more willing and ready to take part in the screening campaign. Among barriers that GPs encountered in the present screening campaign were lack of knowledge and experience about iFOBT, lack of materials and insufficient incentives.
Conclusion: Some limitations influence the voluntary participation of GPs in CRC screening campaign that have to be considered before decisions can be made on the implementation of population-based CRC screening programme in Bulgaria in accordance with European guidelines on best practice.