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Acceptance of a Risk Estimation Tool for Colorectal Cancer Screening

Luckhurst CL, Imperiale TF, Matthias MS. Acceptance of a Risk Estimation Tool for Colorectal Cancer Screening. Paper presented at: National Library of Medicine Informatics Training Annual Conference; 2016 Jun 28; Columbus, OH.


While colonoscopy is the most prevalent screening test for colorectal cancer (CRC), fecal immunochemical testing (FIT) is a guideline-recommended alternative. Identifying persons who may be screened with FIT instead of colonoscopy requires knowing individual patient risk. For CRC screening, risk prediction is a critical element of decision support. A recently published risk estimation tool uses five easily-measured factors (age, sex, a first degree relative with CRC, waist circumference, and cigarette smoking history) to quantify risk. We aimed to learn the impressions of clinicians and patients to the risk estimation tool. In the first phase of this study, we used a semi-structured format to interview clinicians at a VA medical center and a non-VA hospital. Using a paper prototype of the risk estimation tool, we asked about its usefulness to their medical practice. We analyzed the interview transcripts using a grounded theory approach and identified major themes. We found that clinicians thought the tool was clear and easy to use. However, they are unlikely to use it as a decision aid until FIT is more widely endorsed as an acceptable alternative screening test. In phase two of the study, we will interview patients to assess their responses to the tool.

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