CAUSES OF REFUSING MEDICAL EXAMINATION BY PATIENTSWITH SUSPECTED CANCER AS PERCEIVED BY PRIMARYCARE PHYSICIANS IN SOUTH KAZAKHSTAN REGION

Abstract

Objective: To identify the most frequent causes of refusing thorough medical examinations by patients
with suspected cancer as perceived by primary care physicians in South Kazakhstan Region (SKR).
Methods: We performed a cross-sectional study, which included 500 primary care physicians in
SKR. Data collection took place between 01 January 2016 and 14 April 2016). The questionnaire
contained 33 semi-open questions. Filling out time was between 20 and 25 minutes. Only doctors who
worked at policlinics during the time of the study were included. Results are presented absolute
numbers and proportions with 95% confidential intervals (CI).
Results: Fear was the most common cause of patients refusing further medical examination after
cancer was suspected (66.2% (95% CI: 61.8-70.3)). As many as 22.8% (95% CI: 19.2 – 26.7) of the
respondents noted being busy at work and feat to lose it as the main cause of refusal. – Altogether,
11.8% (95% CI: 09.1 - 15.0) reported that patients developed signs of depression. Only 11.0% (95% CI:
8.4-14.1) reported that their patients agreed to visit an oncologist after persuasion while 4.0% (95% of
CI: 2.5-6.2) agreed to undergo a thorough medical examination without hesitation.
Conclusion: For the first time perceptions of primary care physicians on the causes of refusing
medical examination by patients of suspected cancer was studied in SKR. The most common cause
was fear of being diagnosed with cancer. Our results suggest low level of medical literacy in SKR,
particularly on the issues of possibilities of successful treatment of cancer, and warrant information
campaigns among general population to ensure early detection and early initiation of treatment.