Related Experiment Video
Updated: Sep 9, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Effect of Personalized Risk Messages on Uptake of Colorectal Cancer Screening : A Randomized Controlled Trial
Peter H Schwartz1, Susan M Perkins2, Susan M Rawl3
1Department of Medicine, Indiana University School of Medicine; Indiana University Center for Bioethics; and Department of Philosophy, Indiana University School of Liberal Arts, Indianapolis, Indiana (P.H.S.).
Background:
Providing personalized risk information to patients and their providers could improve colorectal cancer (CRC) screening.
Objective:
To determine whether providing information on patient risk for advanced colorectal neoplasia (ACN; which includes CRC and advanced precancerous lesions) to patients and providers affects screening uptake, and to identify effect moderators.
Design:
Randomized controlled trial (2 × 2 factorial design). (ClinicalTrials.gov: NCT04683731).
Setting:
Primary care clinics in 2 health care systems.
Participants:
214 providers and 1084 average-risk patients due for screening.
Intervention:
Participants were randomly assigned to view a CRC screening decision aid with or without a personalized message about ACN risk. Providers were randomly assigned to receive notifications that the patient was due for screening, with or without a personalized message about the patient's ACN risk.
Measurements:
Screening test completion by 6 months. Logistic regression was used to estimate intervention effects.
Results:
Overall, there were no differences in screening uptake or test completion for the provider notification (predicted probabilities, 41.5% vs. 36.4% for personalized vs. generic; difference, 5.1 [95% CI, -1.6 to 11.8] percentage points) or decision aid (predicted probabilities, 36.8% vs. 41.0% for personalized vs. generic; difference, -4.1 [CI, -10.2 to 1.9] percentage points) interventions. Health system was an effect moderator for stool testing. For one health system, the stool testing rate was higher for personalized versus generic provider notification (predicted probabilities, 21.1% vs. 7.9%; difference, 13.2 [CI, 1.6 to 24.8] percentage points) when the decision aid was generic. The stool testing rate was higher for the personalized versus the generic decision aid (predicted probabilities, 21.4% vs. 7.9%; difference, 13.5 [CI, 2.4 to 24.5] percentage points) when the provider notification was generic.
Limitations:
Few participants had high-average ACN risk. Non-English-speaking patients were excluded.
Conclusion:
Although including personalized risk for ACN in a decision aid or provider notification had no overall effect, it increased uptake of stool testing in one health system.
Primary Funding Source:
Patient-Centered Outcomes Research Institute (PCORI).
More Related Videos
Related Concept Videos
02:59Cancer Prevention
Some...
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:12Relative Risk
01:30Cancer Vaccines
Cancer vaccines come in two categories: preventive (prophylactic) and treatment (active). Preventive vaccines, such as the Human Papillomavirus (HPV) vaccine, protect against viruses that cause certain...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...