151 Perceptions and beliefs of GPs on the CSPs (Q53). Despite the various technological solutions, the majority of GPs also expressed a consensus that maintaining personal contact with a GP or GP practice should still be possible (Q52). GPs noted that they do not necessarily feel that a GP is required for these interactions. Instead, there was a greater emphasis on the appropriateness of involving a (specialized) practice-based nurse (Q46). Two GPs in particular addressed the funding concerning the CSPs and prevention in general (Q45, Q47, Q57): “… the budget for primary care will truly have to increase substantially. We … actions within the system could then be funded much more easily”. Other suggestions involved (more) cooperation at both the regional as national level (Q56), and the training of medical students (Q58). One suggestion concerned the CRC-SP in particular. Multiple GPs observed that patients with a positive FIT are much more worried and anxious, than patients with positive outcomes at the other two CSPs. Therefore, they suggested that deeper clarification is needed on the meaning of the FIT for the public. This message should at least contain that a positive FIT, does not (immediately) equal CRC (Q54). Discussion This mixed-methods study aimed to map the role of GPs in the Dutch cancer screening programmes (CSPs), indicate that the CSPs are a regular topic during consultation hours and that GPs in general have a positive attitude towards the CSPs, and towards screening participation. GPs are most often consulted regarding the cervical CSP and the CRCSP, and most questions are related to the outcomes of the screening tests and related follow-up examinations. The current role of GPs is generally evaluated as appropriate by GPs, and they would like to remain involved in the CSPs. GPs are not in favour of inviting screening-eligible people via their practices, or taking on more logistical/organizational tasks, but are willing to empower the CSPs. GPs agreed that they want to be informed on all positive test outcomes, but there was no consensus on knowing the participation status of all, nor all screening outcomes. Several options were proposed to improve the CSPs, particularly aiming to increase screening uptake among populations in socioeconomically disadvantaged positions. To our knowledge, this is the first study to map in-depth the role of the GP regarding all three Dutch CSPs, and then specifically concerning perceptions and beliefs that GPs have about their role(s) and optimalization possibilities. Most of the current literature focusses usually only on one of the CSPs and GP involvement, related to screening uptake and/ or GP attitudes. The findings of our study are consistent with these prior studies. As our findings indicate that GPs generally exhibit a positive attitude toward the CSPs, and they possess the ability to influence screening attendance rates.15-18, 22-24 In addition, we found that GPs are aware of and willing to ensure that individuals with a potentially higher risk 6
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