Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

Which test is best? – A RCT to evaluate family history as a triage tool in screening for colorectal cancer (#536)

Sundresan Naicker 1 , Bettina Meiser 2 , Annabel Goodwin 3 , Judy Kirk 4 , Kristine Barlow-Stewart 5 , Timothy Dobbins 1 , Brandi Baylock 1 , Danielle Mazza 6 , John Emery 7 , Marie Pirotta 8 , Lyndal Trevena 1
  1. School of Public Health, University of Sydney, Sydney, NSW, Australia
  2. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
  3. Sydney South West Area Health Service, NSW Department of health, Sydney, NSW, Australia
  4. Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
  5. Northern Clinical School, University of Sydney, Sydney, NSW, Australia
  6. Department of General Practice, Monash University, Melbourne, Victoria, Australia
  7. School of Primary, Aboriginal and Rural Health Care (SPARHC), University of Western Australia, Perth, Western Australia, Australia
  8. Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia

There has been little effort to systematically screen individuals for colorectal cancer (CRC) according to their familial risk1, despite national guidelines in place2, resulting in a trend toward risk-inappropriate screening3. The study aims to evaluate the utility of an online CRC family history risk tool, in assisting GP triage to improve the uptake of risk appropriate referral for CRC screening. Phase one of this study piloted this risk tool4, which was modified to improve usability for participants. This tool is now being implemented in a large clustered RCT with participants from general practices divided into the intervention (the online CRC familial risk tool plus 12 month follow-up) and control group (12 month follow-up , followed by the online CRC familial risk tool ). The primary outcome of phase two (the RCT) is to measure whether the intervention group (who were able to access the family history website) has a higher proportion of risk appropriate screening after GP triage, when compared to individuals in the control group. Preliminary findings from this RCT (n=60), have shown that this online tool is valid in triaging individuals into an appropriate familial risk category, with five participants at an high familial risk, two at moderate familial risk and 53 at average familial risk, of developing CRC. Online tracking data has shown that individuals successfully complete the tool within 24hrs of logging into the website, while their GP’s receive a faxed copy of their risk report immediately after submission. Telephone feedback with participating general practices has confirmed that these reports are being systematically filed and are ready to be used as a triage tool by the GP. It is expected that this tool will significantly increase the level of risk-appropriate screening in a primary care setting, while gathering epidemiological data about the familial penetrance rates of colorectal cancer in the complete study population (n=7360), when this study concludes in 12 months’ time.