scholarly journals The CRISP-P study: feasibility of a self-completed colorectal cancer risk prediction tool in primary care

2019 ◽  
Vol 36 (6) ◽  
pp. 730-735 ◽  
Author(s):  
Elena C Harty ◽  
Jennifer G McIntosh ◽  
Adrian Bickerstaffe ◽  
Nadira Hewabandu ◽  
Jon D Emery

Abstract Objective Australia and New Zealand have the highest incidence of colorectal cancer (CRC) globally. Our research team has developed a CRC risk prediction tool for use in primary care to increase targeted screening. This study, Colorectal cancer RISk Prediction tool – patient (‘CRISP-P’), aimed to determine the following to inform a future trial design: (i) the feasibility of self-reporting; (ii) the feasibility of recruitment methods; and (iii) the prevalence of CRC risk. Methods Participants aged between 40 and 75 years were recruited consecutively from three primary care waiting rooms. Participants input data into CRISP on a tablet without receiving clinical advice. Feasibility was evaluated using recruitment rate, timely completion, a self-reported ‘ease-of-use’, score and field notes. Prevalence of CRC risk was calculated using the CRISP model. Results Five hundred sixty-one (90%) patients agreed to use the tool and 424 (84%) rated the tool easy to use. Despite this, 41% of people were unable to complete the questions without assistance. Patients who were older, without tertiary education or with English as their second language were more likely to require assistance (P < 0.001). Thirty-nine percent of patients were low risk, 58% at slightly increased and 2.4% were at moderately increased risk of developing colorectal cancer in the next 5 years. Conclusions The tool was perceived as easy to use, although older, less educated people, and patients with English as their second language needed help. The data support the recruitment methods but not the use of a self-completed tool for an efficacy trial.

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S157-S158 ◽  
Author(s):  
M Kabir ◽  
K Curtius ◽  
I Al-Bakir ◽  
C -H R Choi ◽  
T Graham ◽  
...  

2021 ◽  
Author(s):  
Shakira Milton ◽  
Jon D Emery ◽  
Jane Rinaldi ◽  
Joanne Kinder ◽  
Adrian Bickerstaffe ◽  
...  

Abstract BackgroundWe developed a colorectal cancer risk prediction tool (‘CRISP’) to provide individualised risk-based advice for colorectal cancer screening. Using known environmental, behavioural, and familial risk factors, CRISP was designed to facilitate tailored screening advice to patients aged 50 to 74 years in general practice. In parallel to a randomised controlled trial of the CRISP tool, we developed and evaluated an evidence-based implementation strategy.MethodsQualitative methods were used to explore the implementation of CRISP in general practice. Using one general practice in regional Victoria, Australia as a ‘laboratory’, we tested ways to embed CRISP into routine clinical practice. General practitioners, nurses, and a practice manager co-designed the implementation methods with researchers, focussing on existing practice processes that would be sustainable. Researchers interviewed the staff regularly to assess the successfulness of the strategies employed, and implementation methods were adapted throughout the study period in response to feedback from qualitative interviews.The Consolidated Framework for Implementation Research (CFIR) underpinned the development of the interview guide and intervention strategy. Coding was inductive and themes were developed through consensus between the authors. Emerging themes were mapped onto the CFIR domains and a fidelity checklist was developed to ensure CRISP was being used as intended.Results Between December 2016 and September 2019, eleven interviews were conducted, both face-to-face and via videoconferencing (Zoom). All interviews were transcribed verbatim and coded. Themes were mapped onto the following CFIR domains: 1. ‘characteristics of the intervention’: CRISP was valued but time consuming; 2. ‘inner setting’: the practice was open to changing systems; 3. ‘outer setting’: CRISP helped facilitate screening; 4. ‘individual characteristics’: the practice staff were adaptable and able to facilitate adoption of new clinical processes; and 5. ‘processes’: fidelity checking and education was important.ConclusionsThese results describe a novel method for exploring implementation strategies for a colorectal cancer risk prediction tool in the context of a parallel RCT testing clinical efficacy. The study identified successful and unsuccessful implementation strategies using an adaptive methodology over time. This method emphasised the importance of co-design input to make an intervention like CRISP sustainable for use in other practices and with other risk tools.Trial registrationN/A


2017 ◽  
Vol 10 (7) ◽  
pp. 421-430 ◽  
Author(s):  
Artitaya Lophatananon ◽  
Juliet Usher-Smith ◽  
Jackie Campbell ◽  
Joanne Warcaba ◽  
Barbora Silarova ◽  
...  

2021 ◽  
Author(s):  
Minta Thomas ◽  
Lori C Sakoda ◽  
Jeffrey K Lee ◽  
Mark A Jenkins ◽  
Andrea Burnett-Hartman ◽  
...  

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3575
Author(s):  
Chu-Yi Huang ◽  
Yu-Jing Fang ◽  
Alinuer Abulimiti ◽  
Xia Yang ◽  
Lei Li ◽  
...  

Polyamines (including putrescine, spermidine, and spermine) are small, cationic molecules that are necessary for cell proliferation and differentiation. Few studies have examined the association of dietary polyamines intake with colorectal cancer risk. The aim of this study was to evaluate total polyamines, putrescine, spermidine, and spermine intake in relation to colorectal cancer risk in China. In total, 2502 colorectal cancer cases and 2538 age-(5-year interval) and sex-matched controls were recruited from July 2010 to April 2019. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated by multivariable unconditional logistic regression after adjustment for various potential confounding factors. Higher intake of total polyamine, putrescine and spermidine was significantly associated with reduced risk of colorectal cancer. The adjusted ORs for the highest compared with the lowest quartile of intake were 0.60 (95% CI 0.50, 0.72; Ptrend < 0.001) for total polyamines, 0.35 (95% CI 0.29, 0.43; Ptrend < 0.001) for putrescine and 0.79 (95% CI 0.66, 0.95; Ptrend = 0.001) for spermidine, respectively. However, higher intake of spermine was associated with increased risk of colorectal cancer, with an adjusted OR of 1.58 (95% CI 1.29, 1.93; Ptrend < 0.001). This data indicate that higher intake of total polyamines, putrescine and spermidine, as well as lower intake of spermine, is associated with a decreased risk of colorectal cancer.


2018 ◽  
Vol 75 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Wa Mwenga Walasa ◽  
Renee N Carey ◽  
Si Si ◽  
Lin Fritschi ◽  
Jane S Heyworth ◽  
...  

ObjectiveResearch indicates that shiftwork may be associated with increased risks of adverse health outcomes, including some cancers. However, the evidence of an association between shiftwork and colorectal cancer risk is limited and inconclusive. Further, while several possible pathways through which shiftwork might result in cancer have been proposed, few studies have taken these factors into account. We investigated the association between two types of shiftwork (graveyard shiftwork and early-morning shiftwork) and six mechanistic shiftwork variables (including light at night and phase shift) and the risk of colorectal cancer among females in an Australian population-based case–control study. Graveyard shiftwork was the primary exposure of interest.MethodsParticipants (350 cases and 410 controls) completed a lifetime occupational history, and exposure to each of the eight shiftwork variables was assigned to participants through a job exposure matrix. We used logistic regression to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for the association between different shiftwork variables and the risk of colorectal cancer, adjusting for potential demographic, lifestyle and medical confounders.ResultsWorking in an occupation involving long-term exposure (>7.5 years) to graveyard shiftwork was not associated with colorectal cancer risk (adjusted OR 0.95, 95% CI 0.57 to 1.58). Similarly, no increased risks of colorectal cancer were seen for any of the other seven shiftwork variables examined.ConclusionsNo evidence of an increased risk of colorectal cancer among females who had worked in occupations involving shiftwork was observed in this study.


Gene ◽  
2018 ◽  
Vol 673 ◽  
pp. 174-180 ◽  
Author(s):  
Junyi Xin ◽  
Haiyan Chu ◽  
Shuai Ben ◽  
Yuqiu Ge ◽  
Wei Shao ◽  
...  

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