scholarly journals Development and user-testing of a brief decision aid for aspirin as a preventive approach alongside colorectal cancer screening

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lenira Semedo ◽  
Kate J. Lifford ◽  
Adrian Edwards ◽  
Kathy Seddon ◽  
Kate Brain ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Decision Aid ◽  
Community Pharmacists ◽  
Haemorrhagic Stroke ◽  
Risk Information ◽  
Framework Approach ◽  
Bowel Cancer Screening ◽  
Colorectal Cancer Prevention

Abstract Background Several epidemiological and cohort studies suggest that regular low-dose aspirin use independently reduces the long-term incidence and risk of colorectal cancer deaths by approximately 20%. However, there are also risks to aspirin use, mainly gastrointestinal bleeding and haemorrhagic stroke. Making informed decisions depends on the ability to understand and weigh up benefits and risks of available options. A decision aid to support people to consider aspirin therapy alongside participation in the NHS bowel cancer screening programme may have an additional impact on colorectal cancer prevention. This study aims to develop and user-test a brief decision aid about aspirin to enable informed decision-making for colorectal screening-eligible members of the public. Methods We undertook a qualitative study to develop an aspirin decision aid leaflet to support bowel screening responders in deciding whether to take aspirin to reduce their risk of colorectal cancer. The iterative development process involved two focus groups with public members aged 60–74 years (n = 14) and interviews with clinicians (n = 10). Interviews (n = 11) were used to evaluate its utility for decision-making. Analysis was conducted using a framework approach. Results Overall, participants found the decision aid acceptable and useful to facilitate decision-making. They expressed a need for individualised risk information, more detail about the potential risks of aspirin, and preferred risk information presented in pictograms when offered different options. Implementation pathways were discussed, including the possibility of involving different clinicians in the process such as GPs and/or community pharmacists. A range of potentially effective timepoints for sending out the decision aid were identified. Conclusion An acceptable and usable decision aid was developed to support decisions about aspirin use to prevent colorectal cancer.

scholarly journals The Impact of a Novel Computer-Based Decision Aid on Shared Decision Making for Colorectal Cancer Screening

2010 ◽  
Vol 31 (1) ◽  
pp. 93-107 ◽  
Author(s):  
Paul C. Schroy ◽  
Karen Emmons ◽  
Ellen Peters ◽  
Julie T. Glick ◽  
Patricia A. Robinson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Shared Decision Making ◽  
Colorectal Cancer Screening ◽  
Decision Aid ◽  
Shared Decision ◽  
Computer Based ◽  
The Impact

Correlation between Faecal Tumour M2 Pyruvate Kinase and Colonoscopy for the Detection of Adenomatous Neoplasia in a Secondary Care Cohort

2016 ◽  
Vol 25 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Ashley D. Bond ◽  
Michael D. Burkitt ◽  
David Sawbridge ◽  
Bernard M. Corfe ◽  
Chris S. Probert
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Pyruvate Kinase ◽  
Predictive Value ◽  
Screening Programme ◽  
Occult Blood ◽  
Faecal Occult ◽  
Faecal Samples ◽  
Cancer Screening Programme ◽  
Bowel Cancer Screening

Background & Aims: Colorectal cancer screening programmes that target detection and excision of adenomatous colonic polyps have been shown to reduce colorectal cancer related mortality. Many screening programmes include an initial faecal occult blood test (FOBt) prior to colonoscopy. To refine the selection of patients for colonoscopy other faecal-based diagnostic tools have been proposed, including tumour M2-pyruvate kinase (tM2-PK). To determine whether tM2-PK quantification may have a role in diverse settings we have assessed the assay in a cohort of patients derived from both the England bowel cancer screening programme (BCSP) and symptomatic individuals presenting to secondary care. Method. Patients undergoing colonoscopy provided faecal samples prior to bowel preparation. Faecal tM2-PK concentrations were measured by ELISA. Sensitivity, specificity, positive predictive value, negative predictive value and ROC analyses were calculated. Results. Ninety-six patients returned faecal samples: 50 of these with adenomas and 7 with cancer. Median age was 68. Median faecal tM2-PK concentration was 3.8 U/mL for individuals without neoplastic findings at colonoscopy, 7.7 U/mL in those with adenomas and 24.4 U/mL in subjects with colorectal cancer (both, p=0.01). ROC analysis demonstrated an AUROC of 0.66 (sensitivity 72.4%, specificity 48.7%, positive predictive value 67.7%, negative predictive value 36.7%). Amongst BCSP patients with a prior positive FOBt faecal tM2-PK was more abundant (median 6.4 U/mL, p=0.03) and its diagnostic accuracy was greater (AUROC 0.82). Conclusion. Our findings confirm that faecal tM2-PK ELISA may have utility as an adjunct to FOBt in a screening context, but do not support its use in symptomatic patients. Abbreviations: BCSP: Bowel cancer screening programme; EMR: Endoscopic mucosal resection; FAP: Familial adenomatous polyposis; FOBt: Faecal occult blood testing; NHS: National Health Service; tM2-PK: tumour M2-pyruvate kinase.

scholarly journals Are there ethnic and religious variations in uptake of bowel cancer screening? A retrospective cohort study among 1.7 million people in Scotland

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037011
Author(s):  
Christine Campbell ◽  
Anne Douglas ◽  
Linda Williams ◽  
Geneviève Cezard ◽  
David H Brewster ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Ethnic Group ◽  
Colorectal Cancer Screening ◽  
South Asian ◽  
Bowel Cancer ◽  
Index Number ◽  
Adjusted Risk ◽  
Targeted Interventions ◽  
Bowel Cancer Screening

ObjectiveCancer screening should be equitably accessed by all populations. Uptake of colorectal cancer screening was examined using the Scottish Health and Ethnicity Linkage Study that links the Scottish Census 2001 to health data by individual-level self-reported ethnicity and religion.SettingData on 1.7 million individuals in two rounds of the Scottish Bowel Cancer Screening Programme (2007–2013) were linked to the 2001 Census using the Scottish Community Health Index number.Main outcome measureUptake of colorectal cancer screening, reported as age-adjusted risk ratios (RRs) by ethnic group and religion were calculated for men and women with 95% CI.ResultsIn the first, incidence screening round, compared with white Scottish men, Other White British (RR 109.6, 95% CI 108.8 to 110.3) and Chinese (107.2, 95% CI 102.8 to 111.8) men had higher uptake. In contrast, men of all South Asian groups had lower uptake (Indian RR 80.5, 95% CI 76.1 to 85.1; Pakistani RR 65.9, 95% CI 62.7 to 69.3; Bangladeshi RR 76.6, 95% CI 63.9 to 91.9; Other South Asian RR 88.6, 95% CI 81.8 to 96.1). Comparable patterns were seen among women in all ethnic groups, for example, Pakistani (RR 55.5, 95% CI 52.5 to 58.8). Variation in uptake was also observed by religion, with lower rates among Hindu (RR (95%CI): 78.4 (71.8 to 85.6)), Muslim (69.5 (66.7 to 72.3)) and Sikh (73.4 (67.1 to 80.3)) men compared with the reference population (Church of Scotland), with similar variation among women: lower rates were also seen among those who reported being Jewish, Roman Catholic or with no religion.ConclusionsThere are important variations in uptake of bowel cancer screening by ethnic group and religion in Scotland, for both sexes, that require further research and targeted interventions.

scholarly journals Development of a decision aid to support colorectal cancer screening: perspectives of Asians in an endemic urban community—a qualitative research study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sok Wei Julia Yuen ◽  
Tsang Yew Tay ◽  
Ning Gao ◽  
Nian Qin Tho ◽  
Ngiap Chuan Tan
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Decision Aid ◽  
Controlled Trial ◽  
Local Population ◽  
Primary Care Clinic ◽  
Screening Rate ◽  
Care Clinic ◽  
Crc Screening ◽  
Knowledge Deficits

Abstract Background Colorectal cancer (CRC) is a common malignancy worldwide. Despite being the most common cancer in Singapore, CRC screening rate remains low due to knowledge deficits, social reasons such as inconvenience and a lack of reminder or recommendation. A decision aid (DA) may facilitate an individual’s decision-making to undertake CRC screening by addressing misconceptions and barriers. We postulate that a more person-centred and culturally adapted DA will better serve the local population. The views of the target users are thus needed to develop such a DA. A CRC screening DA prototype has been adapted from an American DA to cater to the Asian users. This study aimed to explore user perspectives on an adapted CRC screening DA-prototype in terms of the design, content and perceived utility. Methods The study used in-depth interviews (IDIs) and focus group discussions (FGDs) to gather qualitative data from English-literate multi-ethnic Asian adults aged 50 years old and above. They had yet to screen for CRC before they were recruited from a public primary care clinic in Singapore. The interviews were audio-recorded, transcribed and analysed to identify emergent themes via thematic analysis. Results This study included 27 participants involved in 5 IDI and 5 FGDs. Participants found the DA easily comprehensible and of appropriate length. They appreciated information about the options and proposed having multi-lingual DAs. The design, in terms of the layout, size and font, was well-accepted but there were suggestions to digitalize the DA. Participants felt that the visuals were useful but there were concerns about modesty due to the realism of the illustration. They would use the DA for information-sharing with their family and for discussion with their doctor for decision making. They preferred the doctor’s recommendation for CRC screening and initiating the use of the DA. Conclusions Participants generally had favourable perceptions of the DA-prototype. A revised DA will be developed based on their feedback. Further input from doctors on the revised DA will be obtained before assessing its effectiveness to increase CRC screening rate in a randomized controlled trial.

scholarly journals Exploring the Barriers Toward Colorectal Cancer Screening: A Literature Review

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Rolla Hamdan ◽  
Jessie Johnson ◽  
Maryam Fatemi ◽  
Kathleen Benjamin ◽  
Afrah Moosa
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Blood Test ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Primary Health ◽  
Faecal Occult ◽  
Bowel Cancer Screening

Background: Colorectal cancer is the third most common cancer and the second leading cause of death worldwide. Bowel cancer screening helps prevent colon cancer by early detection of polyps, leading to efficient treatment and reduced mortality. Within Qatar, primary health facilities promote bowel screening by using the faecal occult blood test. However, the popularity and use of this test is still low. Aim: The aim of this literature review is to explore barriers related to colorectal cancer bowel screening using the faecal occult blood test in primary health care settings to facilitate colorectal cancer screening in Qatar. Method: Cronin’s five step framework for literature reviews was utilized for this paper. This review included nine articles that were peer-reviewed and published between 2009 and 2019. The nine articles were appraised by using the Mixed Methods Appraisal Tool. This tool has separate criteria to assess the quality of the qualitative, quantitative, and mixed-method studies. Result: Three main barriers to bowel cancer screening included knowledge deficit, personal beliefs and organizational barriers. Conclusion: The main barriers are related to the patients’ lack of knowledge and personal beliefs. Overcoming these barriers is essential to raising awareness about this issue among all nurses, physicians, and patients. It is necessary to involve stakeholders in order to mitigate barriers. Developing educational activities for healthcare professionals will provide information that they can share with patients to encourage screening and decrease the fear of the test. Developing a pamphlet to increase patient awareness will also encourage screening and work toward decreasing fear. Key words: faecal occult blood test, faecal immunochemical test, barriers

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