Dataset Information

Estimating uptake of colorectal cancer screening tests

ABSTRACT: Background and study aims Bowel cancer is a National Health Service (NHS) priority as 1 in 20 people will develop the disease and half of those will die, equating to 17,000 each year in the UK. Bowel cancer is largely preventable via the timely detection and removal of precancerous growths in the bowel (called adenomas) and chances of survival are improved greatly if bowel cancer is detected early, before the disease causes symptoms. As a result, screening tests for adenomas and bowel cancer in people who do not currently have symptoms are an important method for reducing the number of deaths from bowel cancer. However, the success of any screening test depends on people being willing to be tested so it is essential that tests are as acceptable as possible to invitees in order to maximise uptake. There are several tests that could be used to screen for bowel cancer, each with their own advantages and disadvantages, and there is no clearly superior option. For example, some tests are more accurate than others but screening invitees might consider these to be less convenient than alternatives. It is currently unclear which test people would be most likely to have. It is also uncertain what the specific reasons are that underpin these preferences. This study aims to answer these questions. Who can participate? We are recruiting members of the public who are representative of individuals who have not had bowel cancer screening before but are approaching the age at which it is offered. We are sending out questionnaires to men and women aged 45-54 years via their General Practitioner. We are also using several other criteria to ensure that people in our study are similar to those who would be offered screening. For example, individuals will only be invited to take part if they have not previously had a diagnosis of bowel cancer or already have regular bowel tests for reasons unrelated to screening. What does the study involve? People who are eligible to take part in the study will be posted a questionnaire and written information about one of the four tests that we are investigating. The test that they will receive information about will be randomly determined. Individuals will be asked to read the information and complete the questionnaire, which asks questions on whether they believe they would be willing to have the test and their impressions of the different aspects of the procedure (for example, how convenient or inconvenient it might be for them). Participants will then send the questionnaire back to the main study centre, where we will compare peoples responses across the different tests once they have all been collected.

DISEASE(S): Topic: Primary Care Research Network For England / Colorectal Cancer Screening

PROVIDER: 2424971 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: People aged 40 or older and who have had a recent diagnosis of a bowel condition at colonoscopy will be contacted about this study. This will include people with a main diagnosis of a small adenoma, a significant adenoma, bowel cancer of stage I, II, III or IV, or those with non-neoplastic findings such as diverticular disease or haemorrhoids. Within two weeks after colonoscopy people will be sent a letter inviting them to take part in a questionnaire at this time point and again 12 months later. The questionnaire contains four sections. Section A mainly includes questions about health conditions and any treatment that the person may have received in the past 12 months. Section B contains questions about health-related quality of life and wellbeing. Section C contains questions on attitudes towards managing health. Section D includes questions about the person’s background. If the questionnaire is not returned within two weeks then research staff will make telephone contact with the invitees to follow-up and confirm their willingness or otherwise to participate in the study. Another sub-group of participants will now be included in this study, to capture more information about the quality of life (QOL) from individuals who have completed treatment for colorectal adenocarcinoma (stages I, II, III, IV). A single questionnaire will be offered to individuals who are within 3 years post-surgery/neoadjuvant therapy, after a colorectal cancer (CRC) diagnosis. Primary outcome(s): The primary outcome will be the quality of life in people who have been diagnosed with a bowel condition. This will be assessed by questionnaire using existing surveys- a generic preference-based health related quality of life instrument (the EQ-5D-5L), a cancer-specific quality of life instrument (the EORTC QLQ-C30) and a widely used subjective wellbeing measure (the Satisfaction with Life Scale).[This will be assessed via questionnaire within two weeks and 12 months after colonoscopy.]

Project description:An epidemic disease caused by a new coronavirus has spread in Northern Italy with a strong contagion rate. We implement an SEIR model to compute the infected population and the number of casualties of this epidemic. The example may ideally regard the situation in the Italian Region of Lombardy, where the epidemic started on February 24, but by no means attempts to perform a rigorous case study in view of the lack of suitable data and the uncertainty of the different parameters, namely, the variation of the degree of home isolation and social distancing as a function of time, the initial number of exposed individuals and infected people, the incubation and infectious periods, and the fatality rate. First, we perform an analysis of the results of the model by varying the parameters and initial conditions (in order for the epidemic to start, there should be at least one exposed or one infectious human). Then, we consider the Lombardy case and calibrate the model with the number of dead individuals to date (May 5, 2020) and constrain the parameters on the basis of values reported in the literature. The peak occurs at day 37 (March 31) approximately, with a reproduction ratio R0 of 3 initially, 1.36 at day 22, and 0.8 after day 35, indicating different degrees of lockdown. The predicted death toll is approximately 15,600 casualties, with 2.7 million infected individuals at the end of the epidemic. The incubation period providing a better fit to the dead individuals is 4.25 days, and the infectious period is 4 days, with a fatality rate of 0.00144/day [values based on the reported (official) number of casualties]. The infection fatality rate (IFR) is 0.57%, and it is 2.37% if twice the reported number of casualties is assumed. However, these rates depend on the initial number of exposed individuals. If approximately nine times more individuals are exposed, there are three times more infected people at the end of the epidemic and IFR = 0.47%. If we relax these constraints and use a wider range of lower and upper bounds for the incubation and infectious periods, we observe that a higher incubation period (13 vs. 4.25 days) gives the same IFR (0.6 vs. 0.57%), but nine times more exposed individuals in the first case. Other choices of the set of parameters also provide a good fit to the data, but some of the results may not be realistic. Therefore, an accurate determination of the fatality rate and characteristics of the epidemic is subject to knowledge of the precise bounds of the parameters. Besides the specific example, the analysis proposed in this work shows how isolation measures, social distancing, and knowledge of the diffusion conditions help us to understand the dynamics of the epidemic. Hence, it is important to quantify the process to verify the effectiveness of the lockdown.

Project description:Intervention 1: One group in the study will receive educational intervention. Educational content provided to the intervention group includes an app that is designed based on preventive health model, and an educational pamphlet about colorectal cancer, the importance of screening and a variety of colorectal cancer screening methods. Intervention 2: Control group: One group as a control group will enter the study, that will not receive any training and intervention. Primary outcome(s): Perceived self-efficacy. Timepoint: 2 months after the beginning of the study. Method of measurement: Colorectal screening questionnaire.;Perceived sensitivity. Timepoint: 2 months after the beginning of the study. Method of measurement: Colorectal screening questionnaire.;Worries and fears. Timepoint: 2 months after the beginning of the study. Method of measurement: Colorectal screening questionnaire.;Screening Effectiveness. Timepoint: 2 months after the beginning of the study. Method of measurement: Colorectal screening questionnaire.;Social support. Timepoint: 2 months after the beginning of the study. Method of measurement: Colorectal screening questionnaire.;Behavioral intention. Timepoint: 2 months after the beginning of the study. Method of measurement: Colorectal screening questionnaire. Study Design: Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Single, Purpose: Screening, Randomization description: Samples were randomly selected from 2 centers by block sampling method and samples of both groups will be matched based on demographic variables such as age, education, and so on. Random assignment of selected individuals will be done by block random method using quad blocks. For two groups of intervention and comparison use two letters A and B. So the size of each block is twice the number of groups, that is, the number 4. By dividing the sample size by block size, the number of blocks is determined. Sample size is 160 people. Each group consists of 80 people, and the number of blocks in each group is 20 blocks, each of which specifies the assignment of 4 individuals. Finally, all letters A and B are separated, and each person who is not the researcher, by lot, will be suspended by each letter in a group. For example, A intervention group

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Estimating uptake of colorectal cancer screening tests

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