Journal
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
Volume 24, Issue 9, Pages 1311-1318Publisher
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-15-0150
Keywords
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Funding
- NCI [1R01CA125194-0305]
- Huntsman Cancer Foundation
- Shared Resources at Huntsman Cancer Institute [Biostatistics and Research Design, Genetic Counseling, Research Informatics] [P30 CA042014]
- Shared Resources at Huntsman Cancer Institute [Tissue Resource and Applications Core (TRAC)] [P30 CA042014]
- Shared Resources at Huntsman Cancer Institute [Utah Population Database (UPDB)] [P30 CA042014]
- Utah Cancer Registry - NCI's Surveillance, Epidemiology, and End Results (SEER) Program [HHSN261201000026C]
- Utah State Department of Health
- University of Utah
- California Department of Public Health [103885]
- National Cancer Institute's SEER Program [N01PC-2010-00034C, N01-PC-35139, N01-PC-54404]
- Centers for Disease Control and Prevention's National Program of Cancer Registries [U58CCU000807-05]
- Colorado Central Cancer Registry program in the Colorado Department of Public Health and Environment - National Program of Cancer Registries of the Centers for Disease Control and Prevention
- Cancer Data Registry of Idaho
- National Program of Cancer Registries of the Centers for Disease Control and Prevention
- New Mexico Tumor Registry - NCI [HHSN261201300010I]
- Rocky Mountain Cancer Genetics Network [HHSN261200744000C]
- Huntsman Cancer Registry
- Intermountain Healthcare Oncology Clinical Program and Intermountain Clinical Genetics Institute
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Background: We tested the efficacy of a remote tailored intervention Tele-Cancer Risk Assessment and Evaluation (TeleCARE) compared with a mailed educational brochure for improving colonoscopy uptake among at-risk relatives of colorectal cancer patients and examined subgroup differences based on participant reported cost barriers. Methods: Family members of colorectal cancer patients who were not up-to-date with colonoscopy were randomly assigned as family units to TeleCARE (N = 232) or an educational brochure (N = 249). At the 9-month follow-up, a cost resource letter listing resources for free or reduced-cost colonoscopy was mailed to participants who had reported cost barriers and remained nonadherent. Rates of medically verified colonoscopy at the 15-month follow-up were compared on the basis of group assignment and within group stratification by cost barriers. Results: In intent-to-treat analysis, 42.7% of participants in TeleCARE and 24.1% of participants in the educational brochure group had a medically verified colonoscopy [OR, 2.37; 95% confidence interval (CI) 1.59-3.52]. Cost was identified as a barrier in both groups (TeleCARE = 62.5%; educational brochure = 57.0%). When cost was not a barrier, the TeleCARE group was almost four times as likely as the comparison to have a colonoscopy (OR, 3.66; 95% CI, 1.85-7.24). The intervention was efficacious among those who reported cost barriers; the TeleCARE group was nearly twice as likely to have a colonoscopy (OR, 1.99; 95% CI, 1.12-3.52). Conclusions: TeleCARE increased colonoscopy regardless of cost barriers. Impact: Remote interventions may bolster screening colonoscopy regardless of cost barriers and be more efficacious when cost barriers are absent. (C) 2015 AACR.
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