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Miles A, Paschalidi A, Sharma N. The effect of numeric information about the likelihood of receiving a false negative or false positive result on people's attitudes towards colorectal cancer screening using faecal immunochemical testing (FIT). PATIENT EDUCATION AND COUNSELING 2023; 114:107857. [PMID: 37348310 DOI: 10.1016/j.pec.2023.107857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To examine the impact of numeric risk information about false negative (FN) and false positive (FP) rates in fecal immunochemical testing (FIT) on attitudes towards screening. METHODS 102 people aged 45-55, living in the UK, read 6 hypothetical vignettes presented online about the use of FIT kits to detect colorectal cancer, in which information about FN and FP rates was systematically varied. RESULTS Numeric FN risk information reduced people's interest in screening, perception of screening effectiveness and lowered trust in screening compared to verbal FN information. Verbal FN information reduced perceptions of screening effectiveness and trust compared to no FN information. People with high subjective numeracy reported lower trust in screening following the provision of numeric FN information but numeracy did not moderate any other associations. FP information did not affect attitudes towards FIT testing. CONCLUSION Numeric FN risk information decreased people's perceptions of screening effectiveness and trust in the results of screening. While it influenced people's interest in screening, the effect was small. PRACTICE IMPLICATIONS Numeric FN information has a small effect on interest in screening and could promote informed decision making without affecting screening uptake.
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Affiliation(s)
- Anne Miles
- Department of Psychological Sciences, Birkbeck, University of London, London, UK.
| | - Alexandra Paschalidi
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Navya Sharma
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Gram EG, á Rogvi J, Heiberg Agerbeck A, Martiny F, Bie AKL, Brodersen JB. Methodological Quality of PROMs in Psychosocial Consequences of Colorectal Cancer Screening: A Systematic Review. Patient Relat Outcome Meas 2023; 14:31-47. [PMID: 36941831 PMCID: PMC10024469 DOI: 10.2147/prom.s394247] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/18/2023] [Indexed: 03/15/2023] Open
Abstract
Objective This systematic review aimed to assess the adequacy of measurement properties in Patient-Reported Outcome Measures (PROMs) used to quantify psychosocial consequences of colorectal cancer screening among adults at average risk. Methods We searched four databases for eligible studies: MEDLINE, CINAHL, PsycINFO, and Embase. Our approach was inclusive and encompassed all empirical studies that quantified aspects of psychosocial consequences of colorectal cancer screening. We assessed the adequacy of PROM development and measurement properties for content validity using The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. Results We included 33 studies that all together used 30 different outcome measures. Two PROMs (6.7%) were developed in a colorectal cancer screening context. COSMIN rating for PROM development was inadequate for 29 out of 30 PROMs (97%). PROMs lacked proper cognitive interviews and pilot studies and therefore had no proven content validity. According to the COSMIN checklist, 27 out of 30 PROMs (90%) had inadequate measurement properties for content validity. Discussion The majority of included PROMs had inadequate development and measurement properties. These findings shed light on the trustworthiness of the included studies' findings and call for reevaluation of existing evidence on the psychosocial consequences of colorectal cancer screening. To provide trustworthy evidence about the psychosocial consequences of colorectal cancer screening, editors could require that studies provide evidence of the methodological quality of the PROM. Alternatively, authors should transparently disclose their studies' methodological limitations in measuring psychosocial consequences of screening validly.
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Affiliation(s)
- Emma Grundtvig Gram
- The Center of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Research Unit for General Practice in Region Zealand, Region Zealand, Denmark
- Correspondence: Emma Grundtvig Gram, Email
| | - Jessica á Rogvi
- The Center of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anders Heiberg Agerbeck
- The Center of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Frederik Martiny
- The Center of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Katrine Lykke Bie
- The Center of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brandt Brodersen
- The Center of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Research Unit for General Practice in Region Zealand, Region Zealand, Denmark
- The Research Unit for General Practice, Department of Social Medicine, University of Tromsø, Tromsø, Norway
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Marlow LAV, Schmeising-Barnes N, Brain K, Duncombe S, Robb KA, Round T, Sanderson SC, Waller J. Multi-cancer early detection tests for cancer screening: a behavioural science perspective. Lancet Oncol 2022; 23:837-839. [DOI: 10.1016/s1470-2045(22)00161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 11/29/2022]
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Currais P, Rosa I, Claro I. Colorectal cancer carcinogenesis: From bench to bedside. World J Gastrointest Oncol 2022; 14:654-663. [PMID: 35321283 PMCID: PMC8919024 DOI: 10.4251/wjgo.v14.i3.654] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/18/2021] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) remains one of the main causes of cancer death in developed countries. Yet, it is potentially preventable, by removing the precursor lesions - adenomas or serrated lesions. Several studies proved that this intervention reduces CRC mortality and that the first colonoscopy’s results can guide surveillance strategies. More recently, it became clear that several carcinogenesis pathways may lead to sporadic CRC. CRC is a heterogeneous disease, characterized by multiple molecular subtypes. Three main pathways have been implicated in the development of CRC: Chromosomal instability, microsatellite instability, and the “serrated” pathways, with overlapping features between them. This and other molecular and genetic based CRC classifications are known to have clinical implications, spanning from familial risk assessment to therapy choices. The authors review basic science data and provide insight on current implications for the management of patients with CRC.
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Affiliation(s)
- Pedro Currais
- Department of Gastroenterology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisboa 1099-023, Portugal
| | - Isadora Rosa
- Department of Gastroenterology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisboa 1099-023, Portugal
| | - Isabel Claro
- Department of Gastroenterology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisboa 1099-023, Portugal
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Barnett KN, Weller D, Smith S, Steele RJ, Vedsted P, Orbell S, Moss SM, Melia JW, Patnick J, Campbell C. The contribution of a negative colorectal screening test result to symptom appraisal and help-seeking behaviour among patients subsequently diagnosed with an interval colorectal cancer. Health Expect 2018; 21:764-773. [PMID: 29457677 PMCID: PMC6117494 DOI: 10.1111/hex.12672] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2017] [Indexed: 12/22/2022] Open
Abstract
Background Colorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test (gFOBt) reduce CRC mortality. Interval cancers are diagnosed between screening rounds: reassurance from a negative gFOBt has the potential to influence the pathway to diagnosis of an interval colorectal cancer. Methods Twenty‐six semi‐structured face‐to‐face interviews were carried out in Scotland and England, with individuals diagnosed with an interval colorectal cancer following a negative gFOBt result. Results Participants reported they were reassured by a negative gFOBt, interpreting their result as an “all clear”. Therefore, most did not suspect cancer as a possible cause of symptoms and many did not recall their screening result during symptom appraisal. Among those who did consider cancer, and did think about their screening test result, reassurance from a negative gFOBt led some to “downplay” the seriousness of their symptoms with some interviewees explicitly stating that their negative test result contributed to a delayed decision to seek help. Conclusion Screening participants need to be informed of the limitations of screening and the ongoing risk of developing colorectal cancer even when in receipt of a negative result: the importance of minimizing delay in seeking medical advice for colorectal symptoms should be emphasized.
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Affiliation(s)
| | | | - Steve Smith
- Midlands and NW Bowel Cancer Screening Programme Hub, Rugby, UK
| | | | | | | | - Sue M Moss
- Queen Mary University of London, London, UK
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Colorectal cancer screening: Systematic review of screen-related morbidity and mortality. Cancer Treat Rev 2017; 54:87-98. [DOI: 10.1016/j.ctrv.2017.02.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/02/2017] [Accepted: 02/03/2017] [Indexed: 12/12/2022]
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Miles A, McClements PL, Steele RJC, Redeker C, Sevdalis N, Wardle J. Perceived diagnostic delay and cancer-related distress: a cross-sectional study of patients with colorectal cancer. Psychooncology 2016; 26:29-36. [PMID: 26868950 DOI: 10.1002/pon.4093] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 11/25/2015] [Accepted: 01/15/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study aimed to examine the effect of perceived diagnostic delay on cancer-related distress and determine whether fear of cancer-recurrence and quality of life mediate this relationship. METHODS Cross-sectional study in which 311 colorectal cancer (CRC) survivors in Scotland completed a survey, which included questions on cancer-related distress (IES-R), perceived diagnostic delay, quality of life (trial outcome index of the FACT-C: FACT-C TOI) and fear of cancer recurrence. Fifteen patients withheld consent to data matching with medical records, leaving a sample size of 296. Participants were an average of 69 years old (range 56 to 81) and between 3.5 and 12 years post-diagnosis. Multiple regressions were used to test predictors of distress and regression and bootstrapping to test for mediation. RESULTS Perceived diagnostic delay was correlated with higher cancer-related distress, while objective markers of diagnostic delay (disease stage at diagnosis and treatment received) were not. Some of the relationship between perceived diagnostic delay and cancer-related distress was mediated by quality of life, but not by fear of cancer recurrence. CONCLUSIONS Perceived diagnostic delay was associated with higher cancer-related distress among CRC survivors. While poorer quality of life partly explained such associations, fear of cancer recurrence, stage at diagnosis and treatment did not. The exact features of diagnostic delay that are associated with cancer-related distress remain unclear. Future research should examine the experiences patients go through prior to diagnosis that may increase distress, in an effort to improve our understanding of the factors affecting emotional wellbeing among CRC survivors. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Anne Miles
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Paula L McClements
- Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - Robert J C Steele
- Centre for Research into Cancer Prevention and Screening, Cancer Division, Medical Research Institute, Ninewells Medical School, Dundee, UK
| | - Claudia Redeker
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jane Wardle
- Health Behaviour Research Centre, Institute of Epidemiology and Public Health, University College London, London, UK
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