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Which Test Is Best? A Cluster-Randomized Controlled Trial of a Risk Calculator and Recommendations on Colorectal
Lyndal J Trevena1, Bettina Meiser2, Llewellyn Mills3
1Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Public Health Genomics
|October 4, 2022
Summary
An online tool improved colorectal cancer screening for high-risk individuals. The "Which test is best?" intervention increased risk-appropriate screening and overall screening uptake within 12 months.
Area of Science:
- Oncology
- Public Health
- Health Informatics
Background:
- Colorectal cancer (CRC) screening uptake remains suboptimal.
- Risk-stratified screening approaches are recommended but challenging to implement.
- The
- Which test is best?
- tool was developed to guide screening decisions.
Purpose of the Study:
- To evaluate the effectiveness of an online CRC risk calculator and recommendation tool.
- To assess the impact on risk-appropriate screening (RAS) and CRC screening uptake.
- To compare outcomes between the intervention group and usual care.
Main Methods:
- A cluster-randomized controlled trial involving general practices in Australia.
- Intervention group received an online CRC risk calculator with risk-based recommendations.
- Control group received usual care; outcomes assessed at 12-month follow-up.
Main Results:
- The intervention significantly increased RAS in high-risk participants (80.0% vs. 64.0%).
- Overall Faecal occult blood testing uptake increased by 24.9% in the intervention group versus 15.1% in controls.
- No significant increase in RAS for average- or moderate-risk individuals; non-significant increase in colonoscopies.
Conclusions:
- An online CRC risk calculator with risk-based recommendations effectively increases RAS in high-risk individuals.
- The tool shows potential for improving overall CRC screening uptake.
- Facilitating adherence to risk-based screening guidelines is a key benefit.
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