CRC risk assessment vs education did not promote uptake in screening
The Colorectal Cancer Risk Assessment Tool did not increase colorectal cancer screening participation or intent, according to a study published in the American Journal of Gastroenterology.
“Risk stratification might motivate persons classified as higher CRC risk to complete screening, but unintentionally discourage screening among persons not identified as higher risk,” Timothy Yen, MD, from the department of medicine at Stanford University School of Medicine, and colleagues wrote.
Yen and colleagues randomly assigned 230 patients eligible for first-time CRC screening to either risk assessment via the National Cancer Institute's Colorectal Cancer Risk Assessment Tool (CCRAT) or education as control. At 6 and 12 months, follow-up of screening intent and completion was conducted through a record review or phone.
Investigators used CCRAT risk score tertile to assess change in intent after intervention, time to screening, overall screening completion rates and screening completion.
Results showed time to screening was not different between CCRAT and education control (HR = 0.78; 95% CI, 0.52–1.18). Screening completion was 38.6% with CCRAT and 44% with education, at the 12-month follow-up (OR = 0.8; 95% CI, 0.47–1.3).
“Changes in screening intent did not differ between the risk assessment and education arms (precontemplation to contemplation: OR = 1.52; 95% CI, 0.81–2.86; contemplation to precontemplation: OR = 1.93; 95% CI, 0.45–8.34),” the researchers wrote.
The investigators reported that at 12 months, the top CCRAT risk tertile had a higher screening completion rate (52.6%) compared with the bottom (32.4%) and middle (31.6%) tertiles (P = .10).