title: Patient-clinician information engagement improves adherence to colorectal cancer surveillance after curative treatment: results from a longitudinal study.
abstract: Introduction. Follow-up surveillance after curative treatment for colorectal cancer (CRC) patients is recommended to detect early cancer recurrences and improve survival outcomes. However, a substantial proportion of CRC patients do not undergo cancer surveillance. Several demographic and disease-related factors have been associated with cancer surveillance adherence. Thus far, patient-centered communication has not been studied as a determinant for undergoing cancer surveillance. The purpose of this study is to determine whether patient-clinician information engagement (PCIE) influences patients' self-reported adherence to recommended CRC surveillance procedures.  Methods. The study was a longitudinal survey among Pennsylvanian patients diagnosed with CRC in 2005. CRC patients who were eligible for surveillance and participated in both the baseline and 1-year follow-up surveys were included in this analysis (n = 305). The main outcome measure was self-reported adherence to physical examination, carcinoembryonic antigen testing, and colonoscopy according to recommended guidelines.  Results. Controlling for potential confounders, higher PCIE at baseline predicted a higher odds for CRC patients reporting adherence to recommended surveillance 1 year later by 2.8 times. Other significant predictors of adhering to recommended surveillance were a higher education level and having received systemic therapy.  Discussion. In this longitudinal study among CRC patients who received curative treatment, greater patient engagement with clinicians about cancer-related information was found to improve patients' subsequent adherence to recommended surveillance. This finding provides support for encouraging greater patient-physician communication among CRC patients.
authors.affiliation: Center of Excellence in Cancer Communication Research, Annenberg School for Communication,University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA19104, USA. atan@asc.upenn.edu
authors.forename: Andy S L
authors.initials: AS
authors.lastname: Tan
authors.forename: Mihaela
authors.initials: M
authors.lastname: Moldovan-Johnson
authors.forename: Sarah
authors.initials: S
authors.lastname: Parvanta
authors.forename: Stacy W
authors.initials: SW
authors.lastname: Gray
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
authors.forename: Robert C
authors.initials: RC
authors.lastname: Hornik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000517:prevention & control; D010349:Patient Compliance; D010414:Pennsylvania; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D002272:Carcinoembryonic Antigen