Increasing Colorectal Screening Uptake in Spouses of Patients With Colorectal Cancer Using a Randomized Behavioral Trial

Authors:
Jerrald Lau Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Saw Swee Hock School of Public Health, National University of Singapore, Singapore

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Lina Choe Saw Swee Hock School of Public Health, National University of Singapore, Singapore

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Daphne Hui Juan Lee Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Athena Ming-Gui Khoo Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Wei-Ling Koh Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Cherie Peh Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Alyssa Ng Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Tian-Zhi Lim Division of Surgical Oncology, National University Cancer Institute, Singapore (NCIS), National University Health System, Singapore

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Bettina Lieske Division of Surgical Oncology, National University Cancer Institute, Singapore (NCIS), National University Health System, Singapore
Department of Surgery, National University Hospital, Singapore

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Kuok-Chung Lee Division of Surgical Oncology, National University Cancer Institute, Singapore (NCIS), National University Health System, Singapore
Department of Surgery, National University Hospital, Singapore

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Choon-Seng Chong Division of Surgical Oncology, National University Cancer Institute, Singapore (NCIS), National University Health System, Singapore
Department of Surgery, National University Hospital, Singapore

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Choon-Sheong Seow Division of Colorectal Surgery, Department of General Surgery, Ng Teng Fong General Hospital, Singapore

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Christopher H.L. Keh Division of Colorectal Surgery, Department of General Surgery, Ng Teng Fong General Hospital, Singapore

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Jing-Yu Ng Division of Colorectal Surgery, Department of General Surgery, Ng Teng Fong General Hospital, Singapore

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Ker-Kan Tan Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Division of Surgical Oncology, National University Cancer Institute, Singapore (NCIS), National University Health System, Singapore
Department of Surgery, National University Hospital, Singapore

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Volume/Issue:
Volume 22: Issue 6
Online Publication Date:
29 Jul 2024
DOI:
https://doi.org/10.6004/jnccn.2024.7018
Restricted access

Background: Colorectal cancer (CRC) is one of the few cancers for which screening has been associated with better survival and morbidity, but screening uptake has been underexplored in spouses of existing patients with CRC. The objective of this study was to evaluate whether a brief, structured behavioral intervention delivered to spouses of patients with CRC in a colorectal clinical setting could increase fecal immunochemical test (FIT) uptake within 3 months of the study period. Methods: This study was designed as a block randomized, unblinded, parallel trial conducted in the colorectal outpatient clinics of 2 public tertiary hospitals in Singapore from December 2017 to February 2023. The intervention group received a structured informational pamphlet on CRC screening by the Singapore Ministry of Health and a printed guide with instructions on how to properly use a FIT kit. Results: No significant differences in baseline characteristics were observed between the 2 groups. There was a statistically significant difference (P<.001) in FIT screening uptake between spouses in each group, with 86.2% (n=25) in the intervention group and 38.7% (n=12) in the control group. Conclusions: Our study demonstrated that a brief, structured behavioral intervention offered to spouses accompanying patients with CRC while they wait for the clinic appointment is useful in increasing FIT screening uptake rates. Colorectal clinics can consider setting aside 10 to 15 minutes to educate accompanying spouses in the future as a complementary avenue to holistically promote CRC prevention, subjected to the resources available in each clinic.

ClinicalTrials.gov identifier: NCT04544852

Submitted July 28, 2023; final revision received January 24, 2024; accepted for publication February 1, 2024. Published online July 29, 2024.

Author contributions: Conceptualization: Lim, Tan; Formal analysis: Lau, Choe. Funding acquisition: Lim, Tan. Investigation: Choe, D.H.J. Lee, Khoo, Koh, Peh, A. Ng. Methodology: Lau, Lim, Tan. Supervision: Lim, Lieske, K.C. Lee, Chong, Seow, Keh, J.Y. Ng, Tan. Validation: Choe, D.H.J. Lee, Khoo, Koh. Writing—original draft: Lau, Choe. Writing—review & editing: All authors.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article. All authors are members of the Singapore Colorectal Health Services Research Group.

Funding: Research reported in this publication was supported by the Singapore National Medical Research Council’s Clinician Scientist Award (MOH-000333; K.K. Tan).

Supplementary material: Supplementary material associated with this article is available online at https://doi.org/10.6004/jnccn.2024.7018. The supplementary material has been supplied by the author(s) and appears in its originally submitted form. It has not been edited or vetted by JNCCN. All contents and opinions are solely those of the author. Any comments or questions related to the supplementary materials should be directed to the corresponding author.

Correspondence: Ker-Kan Tan, PhD, Division of Colorectal Surgery, University Surgical Cluster, National University Health System, IE Kent Ridge Road, Singapore 119228. Email: surtkk@nus.edu.sg

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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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Copyright:
Copyright © 2024 by the National Comprehensive Cancer Network 2024
Article Category:
Research Article
Received:
28 Jul 2023
Accepted:
01 Feb 2024
Print Publication Date:
01 Aug 2024
Online Publication Date:
29 Jul 2024

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