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Promoting colorectal cancer screening in first degree relatives of patients with crc



Promoting colorectal cancer screening in first degree relatives of patients with crc



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No 630



CRC screening, starting by age 40, is recommended for FDRs of patients with CRC. Purpose: To determine if a telephone-based educational and counseling intervention can improve CRC screening rates in FDRs of CRC patients. Methods: 1265 consenting FDRs of CRC patients, aged 40-75, were randomized to receive a telephone interview (control group) or the interview plus a brief (12 min), tailored educational and barriers counseling module designed to promote CRC screening (intervention group). Questions about colon cancer screening, potential mediating variables for CRC screening, and barriers to CRC screening were asked at baseline, 3 and 12 months. Odds ratios (OR) of the impact of the intervention on CRC screening after adjustment for demographics were calculated. Results: The baseline screening rate was 45% in both study groups. The 12-month screening rates were significantly higher in the intervention than in the control group (70% vs 58%; OR 1.98; p<0.0001). Despite lower baseline screening rates in the 40-49 year old group than in the older groups (31% vs 51%-74%, p=0.001), the intervention was effective in increasing screening in this youngest subgroup (OR 1.74, p=0.014). Children of CRC patients had lower baseline screening rates than the siblings or parents (35% vs 56% and 63%, p<0.001 after adjustment for age) but the intervention was not effective in increasing CRC screening in this subgroup (OR 1.48, p=0.068). The intervention was somewhat more effective in men (OR 2.51, p=0.0005) than in women (OR 1.58, p=0.018)). The effect of the intervention improved endoscopic (OR 1.83, p<0.0001) but not FOBT screening rates (p=0.25). The intervention favorably affected several mediating variables including knowledge of CRC screening recommendations (p=0.03), efficacy of CRC screening (p=0.0009), perceived CRC risk (p=0.004) and the barrier "unnecessary" (i.e. no symptoms/other behaviors preclude need for CRC screening)(p=0.0007). Conclusions: A brief educational and barriers counseling intervention increased knowledge about CRC screening recommendations, increased perceived efficacy of CRC screening tests, increased the FDRs understanding of their increased risk, decreased self-reported barriers to CRC screening and significantly improved endoscopic CRC screening rates in FDRs of CRC patients. Additional efforts to increase the impact of such interventions on CRC screening should be directed to women, to 40-49 year old FDRs and particularly to the adult children of patients with CRC.

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Accession: 035570814

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