A randomized trial of genetic and environmental risk assessment (GERA) for colorectal cancer risk in primary care: trial design and baseline findings.

PURPOSE: This paper describes an ongoing randomized controlled trial designed to assess the impact of genetic and environmental risk assessment (GERA) on colorectal cancer (CRC) screening. METHODS: The trial includes asymptomatic patients who are 50-79years and are not up-to-date with CRC screening guidelines. Patients who responded to a baseline telephone survey are randomized to a GERA or Control group. GERA group participants meet with a nurse, decide whether to have a GERA blood test (a combination of genetic polymorphism and folate), and, if tested, receive GERA feedback. Follow-up telephone surveys are conducted at 1 and 6months. A chart audit is performed at 6months. RESULTS: Of 2,223 eligible patients, 562 (25%) have enrolled. Patients who enrolled in the study were significantly younger than those who did not (p<0.001). Participants tended to be 50-59years (64%), female (58%), white (52%), married (51%), and have more than a high school education (67%). At baseline, most participants had some knowledge of CRC screening and GERA, viewed CRC screening favorably, and reported that they had decided to do screening. Almost half had worries and concerns about CRC. CONCLUSIONS: One in four eligible primary care patients enrolled in the study. Age was negatively associated with enrollment. Prospective analyses using data for all participants will provide more definitive information on GERA uptake and the impact of GERA feedback.

Colorectal cancer prevention and screening: a Health Belief Model-based research study to increase disease awareness.

The purpose of this quasi-experimental study was to evaluate the effects of a Health Belief Model-based colorectal cancer (CRC) education session on adult participants. Education sessions were conducted at a site chosen by the participants, such as their homes, in a mid-sized, mid-Western city. Thirty-one Caucasian adults participated. Eleven were men (35%) and 20 were women (65%). Study results reveal that the education sessions were an effective way to promote awareness of CRC prevention and screening. The participants' responses reflected a positive and significant (p < .0001) improvement in all areas except beliefs regarding maintenance of a healthy weight (p = .0574). The greatest effect was on men, current smokers, and those with a high school education or less. Education sessions were equally effective for auditory and visual learners. The 31 participants planned to share the information with at least 32 other individuals. The participants acquired an increased awareness of CRC prevention and screening. Willingness to discuss CRC after the education sessions may be significant, especially because the others may, in turn, share the information. Nurses need to be aware of CRC screening guidelines. The impact of patient teaching on this health promotion effort may reach beyond the patients who were in contact with the nurses. Public awareness might be further increased when patients share this information with others.