The Colorectal cancer RISk Prediction (CRISP) trial: a randomised controlled trial of a decision support tool for risk-stratified colorectal cancer screening.

Emery, JD; Jenkins, MA; Saya, S; Chondros, P; Oberoi, J; Milton, S; Novy, K; Habgood, E; Karnchanachari, N; Pirotta, M; Trevena, L; Bickerstaffe, A; De Abreu Lourenço, R; Crothers, A; Ouakrim, DA; Flander, L; Dowty, JG; Walter, FM; Clark, M; Doncovio, S; Etemadmoghadam, D; Fishman, G; Macrae, F; Winship, I; McIntosh, JG

The Colorectal cancer RISk Prediction (CRISP) trial: a randomised controlled trial of a decision support tool for risk-stratified colorectal cancer screening.

Emery, JD Jenkins, MA Saya, S Chondros, P Oberoi, J Milton, S Novy, K Habgood, E Karnchanachari, N Pirotta, M Trevena, L Bickerstaffe, A De Abreu Lourenço, R Crothers, A

Ouakrim, DA Flander, L Dowty, JG Walter, FM Clark, M Doncovio, S Etemadmoghadam, D Fishman, G Macrae, F Winship, I McIntosh, JG

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Publisher:: ROYAL COLL GENERAL PRACTITIONERS
Publication Type:: Journal Article
Citation:: Br J Gen Pract, 2023, 73, (733), pp. e556-e565
Issue Date:: 2023-08

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Field	Value	Language
dc.contributor.author	Emery, JD
dc.contributor.author	Jenkins, MA
dc.contributor.author	Saya, S
dc.contributor.author	Chondros, P
dc.contributor.author	Oberoi, J
dc.contributor.author	Milton, S
dc.contributor.author	Novy, K
dc.contributor.author	Habgood, E
dc.contributor.author	Karnchanachari, N
dc.contributor.author	Pirotta, M
dc.contributor.author	Trevena, L
dc.contributor.author	Bickerstaffe, A
dc.contributor.author	De Abreu Lourenço, R
dc.contributor.author	Crothers, A https://orcid.org/0000-0003-1958-5275
dc.contributor.author	Ouakrim, DA
dc.contributor.author	Flander, L
dc.contributor.author	Dowty, JG
dc.contributor.author	Walter, FM
dc.contributor.author	Clark, M
dc.contributor.author	Doncovio, S
dc.contributor.author	Etemadmoghadam, D
dc.contributor.author	Fishman, G
dc.contributor.author	Macrae, F
dc.contributor.author	Winship, I
dc.contributor.author	McIntosh, JG
dc.date.accessioned	2024-01-19T03:54:27Z
dc.date.available	2022-12-20
dc.date.available	2024-01-19T03:54:27Z
dc.date.issued	2023-08
dc.identifier.citation	Br J Gen Pract, 2023, 73, (733), pp. e556-e565
dc.identifier.issn	0960-1643
dc.identifier.issn	1478-5242
dc.identifier.uri	http://hdl.handle.net/10453/174801
dc.description.abstract	BACKGROUND: A risk-stratified approach to colorectal cancer (CRC) screening could result in a more acceptable balance of benefits and harms, and be more cost-effective. AIM: To determine the effect of a consultation in general practice using a computerised risk assessment and decision support tool (Colorectal cancer RISk Prediction, CRISP) on risk-appropriate CRC screening. DESIGN AND SETTING: Randomised controlled trial in 10 general practices in Melbourne, Australia, from May 2017 to May 2018. METHOD: Participants were recruited from a consecutive sample of patients aged 50-74 years attending their GP. Intervention consultations included CRC risk assessment using the CRISP tool and discussion of CRC screening recommendations. Control group consultations focused on lifestyle CRC risk factors. The primary outcome was risk-appropriate CRC screening at 12 months. RESULTS: A total of 734 participants (65.1% of eligible patients) were randomised (369 intervention, 365 control); the primary outcome was determined for 722 (362 intervention, 360 control). There was a 6.5% absolute increase (95% confidence interval [CI] = -0.28 to 13.2) in risk-appropriate screening in the intervention compared with the control group (71.5% versus 65.0%; odds ratio [OR] 1.36, 95% CI = 0.99 to 1.86, P = 0.057). In those due CRC screening during follow-up, there was a 20.3% (95% CI = 10.3 to 30.4) increase (intervention 59.8% versus control 38.9%; OR 2.31, 95% CI = 1.51 to 3.53, P<0.001) principally by increasing faecal occult blood testing in those at average risk. CONCLUSION: A risk assessment and decision support tool increases risk-appropriate CRC screening in those due screening. The CRISP intervention could commence in people in their fifth decade to ensure people start CRC screening at the optimal age with the most cost-effective test.
dc.format	Electronic-Print
dc.language	eng
dc.publisher	ROYAL COLL GENERAL PRACTITIONERS
dc.relation.ispartof	Br J Gen Pract
dc.relation.isbasedon	10.3399/BJGP.2022.0480
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.classification	4203 Health services and systems
dc.subject.mesh	Humans
dc.subject.mesh	Early Detection of Cancer
dc.subject.mesh	Colorectal Neoplasms
dc.subject.mesh	General Practice
dc.subject.mesh	Australia
dc.subject.mesh	Risk Assessment
dc.subject.mesh	Mass Screening
dc.subject.mesh	Occult Blood
dc.subject.mesh	Humans
dc.subject.mesh	Colorectal Neoplasms
dc.subject.mesh	Mass Screening
dc.subject.mesh	Occult Blood
dc.subject.mesh	Risk Assessment
dc.subject.mesh	Australia
dc.subject.mesh	Early Detection of Cancer
dc.subject.mesh	General Practice
dc.subject.mesh	Humans
dc.subject.mesh	Early Detection of Cancer
dc.subject.mesh	Colorectal Neoplasms
dc.subject.mesh	General Practice
dc.subject.mesh	Australia
dc.subject.mesh	Risk Assessment
dc.subject.mesh	Mass Screening
dc.subject.mesh	Occult Blood
dc.title	The Colorectal cancer RISk Prediction (CRISP) trial: a randomised controlled trial of a decision support tool for risk-stratified colorectal cancer screening.
dc.type	Journal Article
utslib.citation.volume	73
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access	*
dc.date.updated	2024-01-19T03:54:26Z
pubs.issue	733
pubs.publication-status	Published online
pubs.volume	73
utslib.citation.issue	733

Abstract:

BACKGROUND: A risk-stratified approach to colorectal cancer (CRC) screening could result in a more acceptable balance of benefits and harms, and be more cost-effective. AIM: To determine the effect of a consultation in general practice using a computerised risk assessment and decision support tool (Colorectal cancer RISk Prediction, CRISP) on risk-appropriate CRC screening. DESIGN AND SETTING: Randomised controlled trial in 10 general practices in Melbourne, Australia, from May 2017 to May 2018. METHOD: Participants were recruited from a consecutive sample of patients aged 50-74 years attending their GP. Intervention consultations included CRC risk assessment using the CRISP tool and discussion of CRC screening recommendations. Control group consultations focused on lifestyle CRC risk factors. The primary outcome was risk-appropriate CRC screening at 12 months. RESULTS: A total of 734 participants (65.1% of eligible patients) were randomised (369 intervention, 365 control); the primary outcome was determined for 722 (362 intervention, 360 control). There was a 6.5% absolute increase (95% confidence interval [CI] = -0.28 to 13.2) in risk-appropriate screening in the intervention compared with the control group (71.5% versus 65.0%; odds ratio [OR] 1.36, 95% CI = 0.99 to 1.86, P = 0.057). In those due CRC screening during follow-up, there was a 20.3% (95% CI = 10.3 to 30.4) increase (intervention 59.8% versus control 38.9%; OR 2.31, 95% CI = 1.51 to 3.53, P<0.001) principally by increasing faecal occult blood testing in those at average risk. CONCLUSION: A risk assessment and decision support tool increases risk-appropriate CRC screening in those due screening. The CRISP intervention could commence in people in their fifth decade to ensure people start CRC screening at the optimal age with the most cost-effective test.

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http://hdl.handle.net/10453/174801