Translation of Colorectal Cancer Screening Guidelines to Practice: A System Intervention
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ABSTRACT:
DISEASE(S): Colorectal Cancer,Colorectal Neoplasms,Colonic Neoplasms,Cancer
PROVIDER: 2013650 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
Similar Datasets
Project description:The United States Preventive Services Task Force (USPSTF) recommends colorectal cancer (CRC) screening using fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy in adults, beginning at age 50 and continuing until age 75. However, rates of CRC screening remain inadequate. In 2006, only 60.8% of adults 50 or older reported recent CRC screening. Screening rates are even lower among Black and Hispanic populations and in areas with higher poverty rates. Annual or biennial FOBT testing over many years is essential for FOBT to be effective. Few studies have examined the rate of repeat FOBT testing; to the investigators knowledge, none have been conducted in populations with high prevalence of barriers to screening (e.g., low literacy, varied cultural norms, and transportation difficulties). The assumption that FOBT is an effective CRC screening strategy presumes it will be done at least biennially, and cost-effectiveness studies of CRC screening strategies have found that the results are sensitive to the rate of adherence. The investigators study will provide critical information for providers and policymakers as they consider optimal strategies to increase CRC screening among vulnerable populations.
Overall Study Goal: Improve colorectal cancer screening by increasing rates of repeat fecal occult blood testing (FOBT).
Aim 1: Test if a multifaceted intervention increases repeat FOBT testing adherence over a 30-month period
Hypothesis 1: Compared to usual care, the intervention will increase the proportion of patients who complete a repeat annual FOBT within 6 months of their due date.
Hypothesis 2: Compared to usual care, the intervention will increase the proportion of patients who complete 2 additional FOBTs over the 30-month intervention period.
Aim 2: Explore perceived barriers to screening among patients who received the intervention but did not complete repeat FOBT testing within 18 months
Aim 3: Assess the costs of the intervention and the costs per additional repeat screening compared to patients who received usual care.
| 2114310 | ecrin-mdr-crc
Project description:Background and study aims
We carried out a study on subjects with a positive fecal occult blood test performed in the local colorectal cancer screening programme. Our goal was to find the best way to invite these subjects to undergo a total colonoscopy (TC).
Who can participate?
3800 subjects aged 50-69 years old, who attended nine colorectal cancer screening programmes in Italy.
What does the study involve?
The screening programmes invited subjects to undergo a fecal occult blood test (FOBT) every two years. Subjects with a positive FOBT (FOBT+) were invited to undergo a TC. During the study, FOBT+ subjects were randomly allocated to be invited to a TC in different ways:
1. Both first invitation and recall by mail
2. First invitation by phone, recall to non-compliers by mail
3. First invitation by phone, recall by face-to-face counseling with the General Practitioner
4. First invitation by phone, recall by an appointment with a specialist screening practitioner (nurse, healthcare assistant)
At the end of the study, we compared the uptake of TC of the groups of subjects who had received the different types of invitation.
| 2422039 | ecrin-mdr-crc
Project description:Interventions: The intervention is a screening program for CRC that includes the availability of a blood test for CRC.
The intervention group are initially mailed an offer of screening for bowel cancer by FOBT.
At 12 weeks from date of the FOBT-screening offer, subjects who have not participated in FOBT-screening are mailed a second invitation to screen for CRC using a blood test for CRC.
Intervention group subjects contact the study Help-Line to request a referral to a pathology service for a blood to be taken for the blood test.
Primary outcome(s): Completion of a screening test for bowel cancer within a bowel cancer screening program.[12 weeks from written offer of a second screening test.]
Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy
| 2460352 | ecrin-mdr-crc
Project description:Introduction: The potential of expression profiling using microarray analysis as a tool to predict the prognosis for different types of cancer has been realized. This study aimed to identify a novel biomarker for colorectal cancer (CRC). Experimental design: The expression profiles of cancer cells in 153 patients with CRC were examined using laser microdissection and oligonucleotide microarray analysis. Overexpression in CRC cells, especially in patients with distant metastases, was a prerequisite to select candidate genes. We analyzed the protein expression and localization of the candidate gene by immunohistochemical study and investigated the relationship between protein expression and clinicopathologic features in 271 CRC patients. Results: Using microarray analysis, we identified 11 candidate genes related to distant metastases in CRC patients. Among these genes, Traf2- and Nck- interacting kinase (TNIK) was known to be associated with aggressiveness in CRC through Wnt signaling. Absence of overexpression of TNIK protein was associated with significantly better overall survival (p < 0.001) and relapse-free survival (p < 0.001). Moreover, overexpression of TNIK protein was an independent risk factor for CRC recurrence (p = 0.009). Conclusion: Overexpression of TNIK might be a predictive biomarker of CRC recurrence. Copy number analysis was performed using LCM samples of 125 colorectal cancer patients by GeneChip Human Mapping 250k Sty arrays. Non-tumor tissues obtained from 47 patients were used as unpaired reference samples.
2015-11-21 | E-GEOD-64257 | biostudies-arrayexpress
Project description:Interventions: The study aims to improve rates of bowel cancer screening by assessing uptake of Fecal Occult Blood test via General Practice compared to direct mail through the National Bowel Cancer Screening Program.
Subjects will be invited to take part in the study during a routine visit to the GP. The GP or practice nurse will explain the study and provide the subject information and consent forms along with a FOBt kit to take home. How to use the kit will also be explained by the GP or practice nurse along with what the results mean.
The FOBt kit will be completed by the participant at home and mailed to the pathology lab. Results from the kit will be sent by the pathology lab to the participant and the GP and the University NSW assistant researcher collating the data.
If the kit is negative the GP will invite the participant back for another test kit in 2 years time as per medical guidelines. If the test kit is positive the participant will be invited back to see the GP and discuss the next step.
Subjects will be requested to consent to take part in the study for a total period of 6 months. Results of the FOBt will be recorded along with any further investigations which may be required. All data will be non-identifiable. Subjects have the right to withdraw at any time.
Primary outcome(s): On initial presentation to their GP, subjects who have consented to take part in the study will be given information (written & verbal) on bowel cancer screening and offered an FOBt kit.
The number of FOBt kits offered compared to returned kits (results data recorded by the pathology company) will be compared to the same in the National Bowel Cancer Screening Program.[The primary time point (baseline) will be the day of signing the consent form and being given bowel cancer screening education and an FOBt kit.
Once the kits have been dispensed participants are given a time period within which to return them (3 months) and for results to be recorded by the pathology company.
The primary time point is baseline where number of participants are recorded along with number of kits distributed.
]
Study Design: Purpose: Prevention; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Single group;Type of endpoint: Efficacy
| 2461377 | ecrin-mdr-crc
Project description:Introduction: The potential of expression profiling using microarray analysis as a tool to predict the prognosis for different types of cancer has been realized. This study aimed to identify a novel biomarker for colorectal cancer (CRC). Experimental design: The expression profiles of cancer cells in 153 patients with CRC were examined using laser microdissection and oligonucleotide microarray analysis. Overexpression in CRC cells, especially in patients with distant metastases, was a prerequisite to select candidate genes. We analyzed the protein expression and localization of the candidate gene by immunohistochemical study and investigated the relationship between protein expression and clinicopathologic features in 271 CRC patients. Results: Using microarray analysis, we identified 11 candidate genes related to distant metastases in CRC patients. Among these genes, Traf2- and Nck- interacting kinase (TNIK) was known to be associated with aggressiveness in CRC through Wnt signaling. Absence of overexpression of TNIK protein was associated with significantly better overall survival (p < 0.001) and relapse-free survival (p < 0.001). Moreover, overexpression of TNIK protein was an independent risk factor for CRC recurrence (p = 0.009). Conclusion: Overexpression of TNIK might be a predictive biomarker of CRC recurrence. Gene expression profiles for 125 cancer tissues from colorectal cancer patients were measured by Affymetrix HG-U133 Plus 2.0 arrays. Normalization was performed by robust multi-array average (RMA) method under R 2.12.1 statistical software with affy package from BioConductor. The normalized gene expression levels were presented as log2-transformed values by RMA.
2015-11-21 | E-GEOD-64256 | biostudies-arrayexpress
Project description:Introduction: The potential of expression profiling using microarray analysis as a tool to predict the prognosis for different types of cancer has been realized. This study aimed to identify a novel biomarker for colorectal cancer (CRC). Experimental design: The expression profiles of cancer cells in 153 patients with CRC were examined using laser microdissection and oligonucleotide microarray analysis. Overexpression in CRC cells, especially in patients with distant metastases, was a prerequisite to select candidate genes. We analyzed the protein expression and localization of the candidate gene by immunohistochemical study and investigated the relationship between protein expression and clinicopathologic features in 271 CRC patients. Results: Using microarray analysis, we identified 11 candidate genes related to distant metastases in CRC patients. Among these genes, Traf2- and Nck- interacting kinase (TNIK) was known to be associated with aggressiveness in CRC through Wnt signaling. Absence of overexpression of TNIK protein was associated with significantly better overall survival (p < 0.001) and relapse-free survival (p < 0.001). Moreover, overexpression of TNIK protein was an independent risk factor for CRC recurrence (p = 0.009). Conclusion: Overexpression of TNIK might be a predictive biomarker of CRC recurrence.
2015-11-21 | GSE64257 | GEO
Project description:Introduction: The potential of expression profiling using microarray analysis as a tool to predict the prognosis for different types of cancer has been realized. This study aimed to identify a novel biomarker for colorectal cancer (CRC). Experimental design: The expression profiles of cancer cells in 153 patients with CRC were examined using laser microdissection and oligonucleotide microarray analysis. Overexpression in CRC cells, especially in patients with distant metastases, was a prerequisite to select candidate genes. We analyzed the protein expression and localization of the candidate gene by immunohistochemical study and investigated the relationship between protein expression and clinicopathologic features in 271 CRC patients. Results: Using microarray analysis, we identified 11 candidate genes related to distant metastases in CRC patients. Among these genes, Traf2- and Nck- interacting kinase (TNIK) was known to be associated with aggressiveness in CRC through Wnt signaling. Absence of overexpression of TNIK protein was associated with significantly better overall survival (p < 0.001) and relapse-free survival (p < 0.001). Moreover, overexpression of TNIK protein was an independent risk factor for CRC recurrence (p = 0.009). Conclusion: Overexpression of TNIK might be a predictive biomarker of CRC recurrence.
2015-11-21 | GSE64256 | GEO
Project description:Interventions: Name of intervention: gender specific mail-administered screening invitation strategies.
All participants will receive an offer to participate in a free FOBT which will be delivered by mail. Intervention arms will differ from control according to the information included in the materials accompanying the screening offer. All study participants will receive a standard screening reminder irrespective of their intervention group. Intervention materials will target specific psychosocial variables previously identified as being related to male participation in FOBT screening.
The intervention period is 14 weeks. All participants will receive a screening offer according to the following timeline.
Baseline: Advance notification letter sent
Week two: Invitation package sent
Week eight: Reminder letters sent to those who have not completed an FOBT
Week 14: Data collection ceases.
Arm 1: Control
The control arm will receive a standard offer to participate in FOBT screening designed to mimic the strategy utilised by the Australian national bowel cancer screening program (NBCSP).
The standard offer includes an advance notification letter and a screening invitation package.
The advance notification letter is sent two weeks prior to the screening invitation package and is designed to alert participants that an invitation to screen for CRC with an FOBT will soon follow. The standard advance notification letter introduces basic information about colorectal cancer and the health benefits of screening.
The screening invitation package includes a) a screening invitation letter b) an immunochemical FOBT with associated instructions c) an information booklet that describes colorectal cancer and screening and d) a particip
Primary outcome(s): Rate of FOBT participation per trial arm as assessed by number of FOBT screening tests returned.[At 14 weeks from baseline, 12 weeks after receiving the FOBT.]
Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Factorial;Type of endpoint: Efficacy
| 2458819 | ecrin-mdr-crc