Colorectal Neoplasms, Hereditary Nonpolyposis Clinical Trial
Official title:
Implementation of Guidelines on Hereditary or Familial Colorectal Cancer Risk Calculation and Risk Communication
The aim of this study is to improve clinicians' calculation, interpretation and communication of familial colorectal cancer risk, as well as patients' risk perception and uptake of referral for genetic counselling or for surveillance by colonoscopy for their relatives at risk.
Regular colonoscopy is effective in reducing morbidity and mortality due to colorectal cancer
(CRC) in patients at increased familial CRC risk. Currently, the majority of these at-risk
individuals are not properly referred for increased surveillance by colonoscopy or genetic
counselling. In 2008, a national multidisciplinary evidence-based guideline on familial and
hereditary CRC was launched in the Netherlands. Clinicians have new tasks in familial CRC
risk calculation, interpretation and communication. A clustered randomized controlled trial
including an effect, process and cost evaluation will be conducted in eighteen Dutch
hospitals to determine the most cost effective way to implement these new guidelines.
Surgeons and gastroenterologists in both the intervention group and the control group will
receive background information on familial colorectal cancer risk and the guidelines.
Patients and clinicians in the intervention group will receive an additional intervention
strategy.
The effect evaluation is done by assessing the number of CRC patients for whom correct risk
calculation, interpretation and communication is performed, as well as patients' uptake of
the recommended follow up policy. The actual exposure to the different elements of the
implementation procedure and the experiences of users will be assessed in the process
evaluation. The costs of the implementation procedure will be determined by means of a cost
evaluation.
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