Colorectal Cancer Screening Decision Based on Predicted Risk: Protocol for a Pilot Randomized Controlled Trial

Area of Science:

• Oncology
• Preventive Medicine
• Public Health

Background:

• Colorectal cancer (CRC) screening, including fecal immunochemical tests (FIT) and colonoscopy, reduces incidence and mortality.
• Individual CRC risk varies significantly, necessitating personalized screening approaches.
• Current risk-based screening strategies face uncertainties regarding feasibility and efficacy.

Purpose of the Study:

• To evaluate the impact of communicating individual CRC risk and tailored screening recommendations (FIT or colonoscopy) on participants' test choices.
• To assess the feasibility of conducting a larger clinical trial on personalized CRC screening outcomes.

Main Methods:

• A pilot randomized controlled trial involving 880 participants aged 50-69 in Switzerland.
• Participants were stratified by 15-year CRC risk (low, moderate, high) using the QCancer calculator.
• The intervention group received personalized risk information and screening recommendations; the control group received standard information.

Main Results:

• The study anticipates higher appropriate screening uptake in the intervention group compared to the control group.
• No significant difference in overall screening uptake is expected between the groups.
• The pilot aims to inform the design of a full-scale randomized controlled trial.

Conclusions:

• Personalized risk communication can influence appropriate colorectal cancer screening test selection.
• This research will enhance understanding of large-scale, risk-based CRC screening implementation.
• Findings may guide optimized CRC screening strategies, balancing risk-benefit and resource utilization.