My Follow UP – Patient Preference study in Colorectal Adenoma Follow Up Results

Description

Presentation to the Bowel Cancer Screening Programme Colonoscopy QA Subgroup.

Overview of the research provided.

Background
Colorectal cancer (CRC) is a life-threatening disease that kills ~800, 000 annually. Prevention programmes focus on early detection but tackling dietary and lifestyle risk factors could improve outcomes. Understanding preferences for different surveillance programmes involving invasive and non-invasive testing and lifestyle interventions for those with known pre-cancerous lesions could inform potential intervention design.
Methods
A discrete choice experiment was conducted with respondents who had intermediate or high-risk polyps removed during a CRC-screening. Respondents completed 8 sequential choice vignettes which were analysed using latent class (LC) approach.
Results
231 respondents (of 1200 invites), (77.3% male) some (53%) with self-reported high blood pressure, high cholesterol (48.5%) and mean estimated BMI of 28.7 (overweight), demonstrated risk and cost-aversion preferences. Although 39% of respondents were unaware of their CRC risk-status, nearly one in three stated they would make changes to reduce their risk of cancer.
The LC preference analysis revealed three latent classes.
i)Class 1 - significantly favouring phone or email support for a lifestyle change, a 17-month testing interval, with non-invasive testing, and who were risk and cost averse. This class also had a significant aversion to the status quo and a 26.8% membership probability.
ii)Class 2 - preferring the status quo, and strongly risk and cost averse, with a 48.4% membership probability.
iii)Class 3 – characterized by a 24.7% membership probability averse to non-invasive testing, risk and cost.
Conclusions
Respondents were risk and cost averse, with many preferring the status quo. However, with significant discordance between perceived risk versus the known risk of CRC, and low levels of recall of information provided within the current surveillance results indicate necessary improvements. Subgroups of respondents are willing to change behaviours, reflecting a teachable moment, and an opportunity to personalize surveillance.



OUTCOME

Agreement reached with BCSP Colonoscopy QA Subgroup members to initiate the development of regional information to participants in post-polypectomy surveillance.

Period	06 Dec 2018
Held at	Public Health Agency, United Kingdom
Degree of Recognition	Regional