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Colorectal Cancer Screening Based on Predicted Risk: A Randomized Controlled Trial
Ekaterina Plys1, Jean-Luc Bulliard1, Aziz Chaouch1
1Unisanté, University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
The American Journal of Gastroenterology
|January 8, 2025
Summary
Personalized colorectal cancer (CRC) risk information significantly increased risk-appropriate CRC screening uptake. This targeted approach improved screening alignment without affecting overall participation rates.
Area of Science:
- Oncology
- Preventive Medicine
- Public Health
Background:
- Colorectal cancer (CRC) screening commonly utilizes colonoscopy and fecal immunochemical testing (FIT).
- Optimizing CRC screening by aligning methods with individual risk may reduce adverse effects, patient burden, and healthcare costs.
- Personalized risk assessment is crucial for effective cancer prevention strategies.
Purpose of the Study:
- To evaluate the impact of communicating personalized CRC risk and tailored screening recommendations on risk-appropriate screening uptake.
- To assess whether personalized risk communication influences overall screening participation in an organized screening program.
- To determine the effectiveness of a mailed brochure intervention in a general population setting.
Main Methods:
- A randomized controlled trial was conducted in Vaud, Switzerland, involving residents aged 50-69 years.
- The intervention group received a brochure detailing individual 15-year CRC risk and screening advice.
- The control group received standard information comparing FIT and colonoscopy; the primary outcome was risk-appropriate screening at 6 months.
Main Results:
- Risk-appropriate screening completion was significantly higher in the intervention group (37%) compared to the control group (23%), an absolute difference of 14%.
- No significant difference in overall screening uptake was observed between the intervention (50%) and control (49%) groups.
- The study included 258 participants in the intervention arm and 257 in the control arm.
Conclusions:
- Communicating personalized CRC risk and screening recommendations effectively enhances risk-appropriate screening uptake in a general population.
- This personalized approach successfully aligns screening modalities with individual cancer risk without altering overall screening participation.
- The findings suggest a valuable strategy for optimizing CRC screening, resource allocation, and patient outcomes.
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