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The use of a risk assessment and decision support tool (CRISP) compared with usual care in general practice to increase risk-stratified colorectal cancer screening: study protocol for a randomised controlled trial.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Macrae, Finlay 
Winship, Ingrid 
Oberoi, Jasmeen 
Saya, Sibel 

Abstract

BACKGROUND: Australia and New Zealand have the highest incidence rates of colorectal cancer worldwide. In Australia there is significant unwarranted variation in colorectal cancer screening due to low uptake of the immunochemical faecal occult blood test, poor identification of individuals at increased risk of colorectal cancer, and over-referral of individuals at average risk for colonoscopy. Our pre-trial research has developed a novel Colorectal cancer RISk Prediction (CRISP) tool, which could be used to implement precision screening in primary care. This paper describes the protocol for a phase II multi-site individually randomised controlled trial of the CRISP tool in primary care. METHODS: This trial aims to test whether a standardised consultation using the CRISP tool in general practice (the CRISP intervention) increases risk-appropriate colorectal cancer screening compared to control participants who receive standardised information on cancer prevention. Patients between 50 and 74 years old, attending an appointment with their general practitioner for any reason, will be invited into the trial. A total of 732 participants will be randomised to intervention or control arms using a computer-generated allocation sequence stratified by general practice. The primary outcome (risk-appropriate screening at 12 months) will be measured using baseline data for colorectal cancer risk and objective health service data to measure screening behaviour. Secondary outcomes will include participant cancer risk perception, anxiety, cancer worry, screening intentions and health service utilisation measured at 1, 6 and 12 months post randomisation. DISCUSSION: This trial tests a systematic approach to implementing risk-stratified colorectal cancer screening in primary care, based on an individual's absolute risk, using a state-of-the-art risk assessment tool. Trial results will be reported in 2020. TRIAL REGISTRATION: Australian and New Zealand Clinical Trial Registry, ACTRN12616001573448p . Registered on 14 November 2016.

Description

Keywords

Colorectal cancer screening, Decision support, Faecal occult blood test, General practice, Precision medicine, Precision screening, Primary care, Risk assessment tool, Risk-stratified screening, Aged, Clinical Trials, Phase II as Topic, Colorectal Neoplasms, Decision Support Techniques, Early Detection of Cancer, Female, General Practice, Humans, Male, Middle Aged, Multicenter Studies as Topic, Predictive Value of Tests, Primary Health Care, Prognosis, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Time Factors, Victoria

Journal Title

Trials

Conference Name

Journal ISSN

1745-6215
1745-6215

Volume Title

19

Publisher

Springer Science and Business Media LLC