CANCER SCREENING COMPLIANCE IN HEREDITARY COLON CANCER

描述：（申请人的描述）努力减少的成功 结肠直肠癌（CRC）死亡率受到低依从率的限制， 筛选 遗传性非息肉病性结直肠癌（HNPCC）是最常见的 遗传性结肠癌的常见病因。 严密监视从 年龄25岁和/或预防性结肠切除术和每年子宫内膜癌筛查 在高危家庭成员中推荐使用。 我们之前已经证明， 监测和预防性结肠切除术可大大延长预期寿命 HNPCC患者。 然而，没有关于筛查的可用数据 依从率或预防性手术的使用。 此外，我们的初步数据表明，许多患者和医生 不知道需要频繁和早期结肠镜检查， HNPCC结肠外肿瘤监测。 本申请中概述的研究项目解决了其中的几个问题 因素 我们建议评估CRC和结肠外肿瘤的依从性 筛查400例HNPCC家系。 招募患者 从各种临床实践，从初级保健医生到 专门的癌症遗传学诊所 我们将发展一种行为 包括健康护理提供者传递的消息的干预， 教育材料、提醒明信片和激励电话 旨在教育HNPCC患者并促进筛查依从性。 HNPCC 未接受推荐的结直肠癌和子宫内膜癌治疗的患者 筛选将入组一项随机对照初步研究， 与常规护理相比，标准化的行为干预。 癌筛查 然后，将对HNPCC的遵守情况和知识进行比较， 护理和干预小组。 如果干预似乎有效， 在这项初步研究中，我们计划使用已建立的HNPCC进行未来的多中心研究 登记处和合作团体。 干预措施的结构和为此编写的教育材料 研究可以很容易地导出用于临床环境。 研究 计划和教育课程概述了这一建议和机构 提供的支持是专门为候选人设计的， 在遗传学和预防相关的癌症预防研究方面的专业知识 胃肠道癌症的研究，并确保独立的研究生涯。

DESCRIPTION: (Applicant's Description) The success of the effort to decrease colorectal cancer (CRC) mortality is limited by low rates of compliance with screening. Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common cause of hereditary colon cancer. Intensive surveillance beginning at age 25 and/or prophylactic colectomy and annual endometrial cancer screening are recommended in at-risk family members. We have previously shown that surveillance and prophylactic colectomy lead to large gains in life-expectancy for HNPCC patients. However, there are no available data regarding screening compliance rates or use of prophylactic surgery in this high-risk population. In addition, our preliminary data suggest that many patients and physicians are not aware of the need for frequent and early colonoscopy and the need for surveillance for extracolonic tumors in HNPCC. The research projects outlined in this application address several of these factors. We propose to assess compliance with CRC and extracolonic tumor screening in 400 individuals from HNPCC families. Patients will be recruited from a variety of clinical practices ranging from primary care physicians to specialized cancer genetics clinics. We will develop a behavioral intervention that includes health care provider delivered messages, educational materials, reminder post-cards and motivational phone calls designed to educate HNPCC patients and promote screening compliance. HNPCC patients who have not undergone recommended colorectal and endometrial cancer screening will be enrolled in a randomized controlled pilot study of the standardized behavioral intervention compared to usual care. Cancer screening compliance and knowledge about HNPCC will then be compared between the usual care and intervention groups. If the intervention appears to be effective in this pilot study, we plan a future multi-center study using established HNPCC registries and co-operative groups. The structure of the intervention and educational materials developed for this study could easily be exported for use in the clinical setting. The research plan and educational curriculum outlined in this proposal and institutional support provided have been designed specifically for the candidate to develop expertise in cancer prevention research related to the genetics and prevention of gastrointestinal cancer and ensure an independent research career.