The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trial
Abstract Background There is currently no existing evidence on the effects of personalised risk information on uptake of colonoscopy following first line screening for colorectal cancer. This study aimed to measure the impact of providing risk information based on faecal haemoglobin concentration to...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-10-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12916-020-01750-3 |
| _version_ | 1830429656392663040 |
|---|---|
| author | Jayne Digby Ronan E. O’Carroll Julie A. Chambers Robert J. C. Steele |
| author_facet | Jayne Digby Ronan E. O’Carroll Julie A. Chambers Robert J. C. Steele |
| author_sort | Jayne Digby |
| collection | DOAJ |
| description | Abstract Background There is currently no existing evidence on the effects of personalised risk information on uptake of colonoscopy following first line screening for colorectal cancer. This study aimed to measure the impact of providing risk information based on faecal haemoglobin concentration to allow a fully informed choice around whether or not to undergo colonoscopy. Methods Two thousand seven hundred sixty-seven participants from the Scottish Bowel Screening Programme (SBoSP) database, who had not recently been invited for screening, were randomised to receive one of three types of hypothetical risk information materials: (1) numerical risk information (risk categories of one in 40, one in 1600 and one in 3500), (2) categorical risk information (highest, moderate and lowest risk), or (3) positive screening result letter (control group). The primary outcome was the impact of the risk materials on intention to undergo colonoscopy, to allow comparison with the current colonoscopy uptake of 77% for those with a positive screening result in the SBoSP. Secondary outcomes were knowledge, attitudes and emotional responses to the materials. Results Four hundred thirty-four (15.7%) agreed to participate with 100 from the numerical risk group (69.0%), 104 from the categorical risk group (72.2%) and 104 from the control group (71.7%) returning completed materials. Intention to undergo colonoscopy was highest in the highest risk groups for the numerical and categorical study arms (96.8% and 95.3%, respectively), but even in the lowest risk groups was > 50% (58.1% and 60.7%, respectively). Adequate knowledge of colorectal screening and the risks and benefits of colonoscopy was found in ≥ 98% of participants in all three arms. All participants reported that they found the information easy-to-understand. 19.1%, 24.0% and 29.6% of those in the numerical, categorical and control group, respectively, reported that they found the information distressing (p > 0.05). Conclusions Applying the risk categories to existing SBoSP data shows that if all participants were offered an informed choice to have colonoscopy, over two thirds of participants would intend to have the test. Equating to an increase in the number of screening colonoscopies from approx. 14,000 to 400,000 per annum, this would place an unmanageable demand on colonoscopy services, with a very small proportion of cancers and pre-cancers detected. However, the response to the materials were very positive, suggesting that providing risk information to those in lowest and moderate risk groups along with advice that colonoscopy is not currently recommended may be an option. Future research would be required to examine actual uptake. Trial registration Date applied 1 December 2017 ISRCTN number 14254582 . |
| first_indexed | 2024-12-21T01:35:18Z |
| format | Article |
| id | doaj.art-1a5951085dc249fd9b20d177d6919a73 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-21T01:35:18Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-1a5951085dc249fd9b20d177d6919a732022-12-21T19:20:16ZengBMCBMC Medicine1741-70152020-10-0118111310.1186/s12916-020-01750-3The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trialJayne Digby0Ronan E. O’Carroll1Julie A. Chambers2Robert J. C. Steele3Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital and Medical SchoolDivision of Psychology, University of StirlingDivision of Psychology, University of StirlingCentre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital and Medical SchoolAbstract Background There is currently no existing evidence on the effects of personalised risk information on uptake of colonoscopy following first line screening for colorectal cancer. This study aimed to measure the impact of providing risk information based on faecal haemoglobin concentration to allow a fully informed choice around whether or not to undergo colonoscopy. Methods Two thousand seven hundred sixty-seven participants from the Scottish Bowel Screening Programme (SBoSP) database, who had not recently been invited for screening, were randomised to receive one of three types of hypothetical risk information materials: (1) numerical risk information (risk categories of one in 40, one in 1600 and one in 3500), (2) categorical risk information (highest, moderate and lowest risk), or (3) positive screening result letter (control group). The primary outcome was the impact of the risk materials on intention to undergo colonoscopy, to allow comparison with the current colonoscopy uptake of 77% for those with a positive screening result in the SBoSP. Secondary outcomes were knowledge, attitudes and emotional responses to the materials. Results Four hundred thirty-four (15.7%) agreed to participate with 100 from the numerical risk group (69.0%), 104 from the categorical risk group (72.2%) and 104 from the control group (71.7%) returning completed materials. Intention to undergo colonoscopy was highest in the highest risk groups for the numerical and categorical study arms (96.8% and 95.3%, respectively), but even in the lowest risk groups was > 50% (58.1% and 60.7%, respectively). Adequate knowledge of colorectal screening and the risks and benefits of colonoscopy was found in ≥ 98% of participants in all three arms. All participants reported that they found the information easy-to-understand. 19.1%, 24.0% and 29.6% of those in the numerical, categorical and control group, respectively, reported that they found the information distressing (p > 0.05). Conclusions Applying the risk categories to existing SBoSP data shows that if all participants were offered an informed choice to have colonoscopy, over two thirds of participants would intend to have the test. Equating to an increase in the number of screening colonoscopies from approx. 14,000 to 400,000 per annum, this would place an unmanageable demand on colonoscopy services, with a very small proportion of cancers and pre-cancers detected. However, the response to the materials were very positive, suggesting that providing risk information to those in lowest and moderate risk groups along with advice that colonoscopy is not currently recommended may be an option. Future research would be required to examine actual uptake. Trial registration Date applied 1 December 2017 ISRCTN number 14254582 .http://link.springer.com/article/10.1186/s12916-020-01750-3Informed choicePersonalised riskFaecal immunochemical testColorectal cancer screening |
| spellingShingle | Jayne Digby Ronan E. O’Carroll Julie A. Chambers Robert J. C. Steele The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trial BMC Medicine Informed choice Personalised risk Faecal immunochemical test Colorectal cancer screening |
| title | The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trial |
| title_full | The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trial |
| title_fullStr | The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trial |
| title_full_unstemmed | The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trial |
| title_short | The impact of hypothetical PErsonalised Risk Information on informed choice and intention to undergo Colorectal Cancer screening colonoscopy in Scotland (PERICCS)—a randomised controlled trial |
| title_sort | impact of hypothetical personalised risk information on informed choice and intention to undergo colorectal cancer screening colonoscopy in scotland periccs a randomised controlled trial |
| topic | Informed choice Personalised risk Faecal immunochemical test Colorectal cancer screening |
| url | http://link.springer.com/article/10.1186/s12916-020-01750-3 |
| work_keys_str_mv | AT jaynedigby theimpactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial AT ronaneocarroll theimpactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial AT julieachambers theimpactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial AT robertjcsteele theimpactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial AT jaynedigby impactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial AT ronaneocarroll impactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial AT julieachambers impactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial AT robertjcsteele impactofhypotheticalpersonalisedriskinformationoninformedchoiceandintentiontoundergocolorectalcancerscreeningcolonoscopyinscotlandpericcsarandomisedcontrolledtrial |