Facilitating informed decisions regarding microsatellite instability testing among high-risk individuals diagnosed with colorectal cancer.
OBJECTIVE
To evaluate the impact of a CD-ROM intervention in the education of patients with suspected Lynch syndrome (LS) about microsatellite instability (MSI) and immunohisochemistry (IHC) testing.


METHODS
Two hundred thirteen patients meeting Bethesda criteria were randomly assigned to receive either a brief educational session with a health educator (n = 105) or a brief educational session plus a CD-ROM (n = 108). Assessments were administered at baseline and 2 weeks post-treatment. Primary outcomes included MSI and IHC knowledge and level of satisfaction with and completeness of the preparation to make the decision for MSI testing. Secondary outcomes included decisional conflict, difficulty making the decision, cancer-specific and global anxiety, and level of discussion about MSI testing with family and friends.


RESULTS
Participants in the education plus CD-ROM condition reported significant increases in knowledge about the MSI and IHC tests, greater satisfaction with the preparation to make a decision for testing, lower decisional conflict, and greater decisional self-efficacy. The effects of the education plus CD-ROM on most outcomes were not moderated by preintervention levels of exposure to MSI testing, family support for MSI testing, or the family history of cancer.


CONCLUSIONS
Incorporation of new media education strategies for individuals at risk for LS may be a valuable component of the informed consent process. As clinical criteria for MSI and IHC testing continue to expand, the need for alternative educational approaches to meet this increased demand could be met by the self-administered computer-based strategy that we described.
Fox Chase Cancer Center, Philadelphia, PA 19111, USA. Sharon.Manne@fccc.edu
Sharon L
SL
Manne
Neal J
NJ
Meropol
David S
DS
Weinberg
Hetal
H
Vig
Zohra
Z
Ali-Khan Catts
Cheri
C
Manning
Eric
E
Ross
Kristen
K
Shannon
Daniel C
DC
Chung
D000328:Adult; D016251:CD-ROM; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics*; D005260:Female; D005820:Genetic Testing; D006801:Humans; D007258:Informed Consent; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods*; D014481:United States