Background and Aims
Siblings of colorectal cancer (CRC) patients are at increased risk of developing CRC,
but screening rates remain low. Through a randomized behavioral intervention, this
study aimed to determine whether patients can advocate screening to their siblings
using a tailored educational package.
Methods
CRC survivors were recruited and randomized into relaying either tailored materials
(intervention group) or existing national screening guidelines (control group) to
their siblings. Siblings could respond to the study team if they were interested in
learning about CRC screening. Study outcomes were patient advocacy rates (number of
patients who had successfully contacted at least 1 eligible sibling) between groups
and the proportion of eligible siblings who responded.
Results
Between May 2017 and March 2021, 219 CRC patients were randomized to the intervention
(n = 110) and control (n = 109) groups. Patient advocacy rates were high and did not
differ significantly between groups. However, only 14.3% of eligible siblings (n =
85) responded to the study team. Siblings of patients from the intervention group
were more likely to respond (adjusted odds ratio, 1.8; 95% confidence interval, 1.1-3.0;
P < .05). Moreover, after controlling for potential confounders, siblings aged ≥60
years were significantly less likely to respond (adjusted odds ratio, .3; 95% confidence
interval, .1-.7; P < .01).
Conclusions
CRC patients are willing advocates of screening, and siblings contacted by patients
from the intervention group were also more likely to reach out to the study team.
However, overall sibling response rates were low despite advocacy, suggesting that
patient-led advocacy should at best be used as an adjunct to other, multipronged CRC
screening promotion modalities.
Graphical abstract
Graphical Abstract
Abbreviations:
CRC (colorectal cancer), FDR (first-degree relative), PDPA (Personal Data Protection Act)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 09, 2021
Accepted:
November 20,
2021
Received:
October 15,
2021
Footnotes
DISCLOSURE: All authors disclosed no financial relationships. Research support for this study (Ker Kan Tan) was provided by the Singapore Ministry of Health’s National Medical Research Council's Health Services Research Grant (NMRC/HSRG/0076/2017) and Clinician Scientist Award, Investigator Category (MOH-000333-CSAINV19may-0009).
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