Cancer Control Research
5R01CA075367-02
Bastani, Roshan
COLORECTAL CANCER SCREENING IN HIGH RISK INDIVIDUALS
AbstractDESCRIPTION (adapted from investigator's abstract): This project will focus
on first degree relatives of colorectal cancer cases who are at higher risk
for developing this cancer than other individuals of the same age. Despite
their increased risk, screening rates among these individuals experience
psychological distress and that this distress may actually function as a
barrier to screening. Therefore, the interventions in this project are
designed to increase utilization of screening (FOBT and
sigmoidoscopy/colonscopy) and decrease psychological distress in a
population based sample of first degree relatives of colorectal cancer cases
obtained from the statewide California Tumor Registry. Equal samples of
randomly selected White, African American, and Latino cases, stratified by
age at diagnosis of the case (<55 vs >55), will be obtained from the
registry. First degree relatives (aged 50-74) identified by the cases will
be administered a baseline telephone interview to assess eligibility,
specific risk factors, past colorectal cancer screening, psychological
distress and other variables from our theoretical framework. Only those
relatives who have not had a FOBT in the past 12 months and/or
sigmoidoscopy/colonoscopy in the past 3 years will be recruited for the
intervention study. Following randomization, one intervention group (n=553)
will receive a mailed personalized risk notification. The second
intervention group (n=553) will receive the mailed intervention followed 1-2
weeks later by a psycho-educational telephone counseling intervention that
will discuss each individual's personal colorectal cancer risk, explore
personal barriers to screening and address psychological issues related to
knowledge of risk status. The control group (n=553) will not receive any
intervention material until after completion of the study. Subjects in all
three groups will be contacted at 6 months post baseline to assess the
effectiveness of the intervention in increasing adherence to colorectal
cancer screening and reducing psychological distress. Secondary analysis
will examine the predictive value of our theoretical framework in modeling
adherence behavior and psychological distress. Cost effectiveness of the
intervention will also be assessed.
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