title: Colon cancer patient information seeking and the adoption of targeted therapy for on-label and off-label indications.
abstract: BACKGROUND
  Despite the rise in publicly available cancer information, little is known about the association between patient information seeking and the adoption of cancer technologies. The authors of this report investigated the relation between patient information seeking and awareness about and receipt of novel targeted therapy (TT) for colon cancer among patients for whom therapy is approved by the US Food and Drug Administration (FDA) and among patients for whom therapy is not FDA approved.
  
  
  METHODS
  A retrospective, population-based survey of 633 colon cancer patients were identified through the Pennsylvania Cancer Registry. Outcome measures were self-reported awareness about and receipt of TT (bevacizumab and cetuximab).
  
  
  RESULTS
  After adjusting for sociodemographic characteristics, high levels of treatment information seeking were associated strongly with hearing about TT (odds ratio [OR], 2.83; 95% confidence interval [CI], 1.49-5.38) and receiving TT (OR, 3.22; 95% CI, 1.36-7.62). These associations were present for patients with metastatic disease, for whom the use of TT is FDA approved, and for patients with localized disease, for whom the use of TT is not FDA approved (P for interactions = .29). Internet use (OR, 2.88; 95% CI, 1.40-5.94) and newspaper/magazine use (OR, 3.44; 95% CI, 1.34-8.84) were associated with hearing about TT. Seeking information from nontreating physicians was associated with hearing about TT (OR, 1.95; 95% CI, 1.03-3.68) and receiving TT (OR, 2.64; 95% CI, 1.16-5.97).
  
  
  CONCLUSIONS
  Patient information seeking was related to the adoption of TT for colon cancer in both appropriate and inappropriate clinical settings. These findings emphasize the importance of exploring patient influence on physician prescribing patterns and understanding the impact of information seeking on cancer outcomes.
authors.affiliation: Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. stacyw_gray@dfci.harvard.edu
authors.forename: Stacy W
authors.initials: SW
authors.lastname: Gray
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
authors.forename: Angela
authors.initials: A
authors.lastname: Demichele
authors.forename: J Sanford
authors.initials: JS
authors.lastname: Schwartz
authors.forename: Robert C
authors.initials: RC
authors.lastname: Hornik
mesh_terms: D022126:Access to Information; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D000068818:Cetuximab; D003110:Colonic Neoplasms / Q000188:drug therapy*; D054626:Consumer Health Information; D016503:Drug Delivery Systems; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance; D012189:Retrospective Studies
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D000068818:Cetuximab