A randomized trial to increase colonoscopy screening in members of high-risk families in the colorectal cancer family registry and cancer genetics network

Jan T. Lowery, Nora Horick, Anita Y. Kinney, Dianne M. Finkelstein, Kathleen Garrett, Robert W. Haile, Noralane Morey Lindor, Polly A. Newcomb, Robert S. Sandler, Carol Burke, Deirdre A. Hill, Dennis J. Ahnen

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Individuals with a strong family history of colorectal cancer have significant risk for colorectal cancer, although adherence to colonoscopy screening in these groups remains low. This study assessed whether a tailored telephone counseling intervention can increase adherence to colonoscopy in members of high-risk families in a randomized, controlled trial. Methods: Eligible participants were recruited from two national cancer registries if they had a first-degree relative with colorectal cancer under age 60 or multiple affected family members, which included families that met the Amsterdam criteria for hereditary non-polyposis colon cancer (HNPCC), and if they were due for colonoscopy within 24 months. Participants were randomized to receive a tailored telephone intervention grounded in behavioral theory or a mailed packet with general information about screening. Colonoscopy status was assessed through follow-up surveys and endoscopy reports. Cox proportional hazards models were used to assess intervention effect. Results: Of the 632 participants (ages 25-80), 60% were female, the majority were White, non-Hispanic, educated, and had health insurance. Colonoscopy adherence increased 11 percentage points in the tailored telephone intervention group, compared with no significant change in the mailed group. The telephone intervention was associated with a32%increase in screening adherence compared with the mailed intervention (HR, 1.32; P 1/4 0.01). Conclusions: A tailored telephone intervention can effectively increase colonoscopy adherence in high-risk persons. This intervention has the potential for broad dissemination to healthcare organizations or other high-risk populations. Impact: Increasing adherence to colonoscopy among persons with increased colorectal cancer risk could effectively reduce incidence and mortality from this disease.

Original languageEnglish (US)
Pages (from-to)601-610
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume23
Issue number4
DOIs
StatePublished - 2014

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Colonoscopy
Registries
Colorectal Neoplasms
Telephone
Neoplasms
Health Insurance
Proportional Hazards Models
Colonic Neoplasms
Endoscopy
Counseling
Randomized Controlled Trials
Organizations
Delivery of Health Care
Mortality
Incidence
Population

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Medicine(all)

Cite this

A randomized trial to increase colonoscopy screening in members of high-risk families in the colorectal cancer family registry and cancer genetics network. / Lowery, Jan T.; Horick, Nora; Kinney, Anita Y.; Finkelstein, Dianne M.; Garrett, Kathleen; Haile, Robert W.; Lindor, Noralane Morey; Newcomb, Polly A.; Sandler, Robert S.; Burke, Carol; Hill, Deirdre A.; Ahnen, Dennis J.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 23, No. 4, 2014, p. 601-610.

Research output: Contribution to journalArticle

Lowery, JT, Horick, N, Kinney, AY, Finkelstein, DM, Garrett, K, Haile, RW, Lindor, NM, Newcomb, PA, Sandler, RS, Burke, C, Hill, DA & Ahnen, DJ 2014, 'A randomized trial to increase colonoscopy screening in members of high-risk families in the colorectal cancer family registry and cancer genetics network', Cancer Epidemiology Biomarkers and Prevention, vol. 23, no. 4, pp. 601-610. https://doi.org/10.1158/1055-9965.EPI-13-1085
Lowery, Jan T. ; Horick, Nora ; Kinney, Anita Y. ; Finkelstein, Dianne M. ; Garrett, Kathleen ; Haile, Robert W. ; Lindor, Noralane Morey ; Newcomb, Polly A. ; Sandler, Robert S. ; Burke, Carol ; Hill, Deirdre A. ; Ahnen, Dennis J. / A randomized trial to increase colonoscopy screening in members of high-risk families in the colorectal cancer family registry and cancer genetics network. In: Cancer Epidemiology Biomarkers and Prevention. 2014 ; Vol. 23, No. 4. pp. 601-610.
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AU - Finkelstein, Dianne M.

AU - Garrett, Kathleen

AU - Haile, Robert W.

AU - Lindor, Noralane Morey

AU - Newcomb, Polly A.

AU - Sandler, Robert S.

AU - Burke, Carol

AU - Hill, Deirdre A.

AU - Ahnen, Dennis J.

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N2 - Background: Individuals with a strong family history of colorectal cancer have significant risk for colorectal cancer, although adherence to colonoscopy screening in these groups remains low. This study assessed whether a tailored telephone counseling intervention can increase adherence to colonoscopy in members of high-risk families in a randomized, controlled trial. Methods: Eligible participants were recruited from two national cancer registries if they had a first-degree relative with colorectal cancer under age 60 or multiple affected family members, which included families that met the Amsterdam criteria for hereditary non-polyposis colon cancer (HNPCC), and if they were due for colonoscopy within 24 months. Participants were randomized to receive a tailored telephone intervention grounded in behavioral theory or a mailed packet with general information about screening. Colonoscopy status was assessed through follow-up surveys and endoscopy reports. Cox proportional hazards models were used to assess intervention effect. Results: Of the 632 participants (ages 25-80), 60% were female, the majority were White, non-Hispanic, educated, and had health insurance. Colonoscopy adherence increased 11 percentage points in the tailored telephone intervention group, compared with no significant change in the mailed group. The telephone intervention was associated with a32%increase in screening adherence compared with the mailed intervention (HR, 1.32; P 1/4 0.01). Conclusions: A tailored telephone intervention can effectively increase colonoscopy adherence in high-risk persons. This intervention has the potential for broad dissemination to healthcare organizations or other high-risk populations. Impact: Increasing adherence to colonoscopy among persons with increased colorectal cancer risk could effectively reduce incidence and mortality from this disease.

AB - Background: Individuals with a strong family history of colorectal cancer have significant risk for colorectal cancer, although adherence to colonoscopy screening in these groups remains low. This study assessed whether a tailored telephone counseling intervention can increase adherence to colonoscopy in members of high-risk families in a randomized, controlled trial. Methods: Eligible participants were recruited from two national cancer registries if they had a first-degree relative with colorectal cancer under age 60 or multiple affected family members, which included families that met the Amsterdam criteria for hereditary non-polyposis colon cancer (HNPCC), and if they were due for colonoscopy within 24 months. Participants were randomized to receive a tailored telephone intervention grounded in behavioral theory or a mailed packet with general information about screening. Colonoscopy status was assessed through follow-up surveys and endoscopy reports. Cox proportional hazards models were used to assess intervention effect. Results: Of the 632 participants (ages 25-80), 60% were female, the majority were White, non-Hispanic, educated, and had health insurance. Colonoscopy adherence increased 11 percentage points in the tailored telephone intervention group, compared with no significant change in the mailed group. The telephone intervention was associated with a32%increase in screening adherence compared with the mailed intervention (HR, 1.32; P 1/4 0.01). Conclusions: A tailored telephone intervention can effectively increase colonoscopy adherence in high-risk persons. This intervention has the potential for broad dissemination to healthcare organizations or other high-risk populations. Impact: Increasing adherence to colonoscopy among persons with increased colorectal cancer risk could effectively reduce incidence and mortality from this disease.

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