Can a print-based intervention increase screening for first degree relatives of people with colorectal cancer? A randomised controlled trial.
OBJECTIVE
To test the effectiveness of a targeted print-based intervention to improve screening adherence in first degree relatives of people with colorectal cancer (CRC).


METHODS
People with CRC and their adult first degree relatives were identified through a population-based cancer registry and randomly allocated as a family unit to the intervention or control condition. The control group received general information about CRC screening. The intervention group received printed advice regarding screening that was targeted to their risk level. Screening adherence was assessed at baseline and at 12 months via self report.


RESULTS
752 (25%) index cases and 574 (34%) eligible first degree relatives consented to take part in the trial and completed baseline interviews. At 12 months, 58% of first degree relatives in the control group and 61% in the intervention group were adherent to screening guidelines (mixed effects logistic regression group by time interaction effect =2.7; 95%CI=1.2-5.9; P=0.013). Subgroup analysis indicated that the intervention was only effective for those with the lowest risk.


CONCLUSIONS
Provision of personalised risk information may have a modest effect on adherence to CRC screening recommendations among first degree relatives of people diagnosed with CRC.


CONCLUSIONS
Improved strategies for identifying and engaging first degree relatives are needed to maximise the population impact of the intervention.
Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, New South Wales.|Hunter Medical Research Institute (HMRI), New South Wales.
Mariko
M
Carey
Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, New South Wales.|Hunter Medical Research Institute (HMRI), New South Wales.
Robert
R
Sanson-Fisher
University of Melbourne, Victoria.|Cancer Council Victoria.|Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Victoria.
Finlay
F
Macrae
Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, New South Wales.|Hunter Medical Research Institute (HMRI), New South Wales.
Emilie
E
Cameron
University of Melbourne, Victoria.|Cancer Council Victoria.
David
D
Hill
National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australian Capital Territory.
Catherine
C
D'Este
Cancer Council Victoria.
Jody
J
Simmons
School of Human, Health and Social Sciences, Central Queensland University.
Christopher
C
Doran
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D013664:Teaching Materials
Fecal Occult Blood Test; bowel cancer; colorectal cancer; familial risk; population screening; targeted advice