Discussing Stopping Cancer Screening and Prognosis With Older Adults

NCT03480282 | Completed Results

• 2 other identifiers: 2016P000244R21CA212386
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 2

Brief Summary

Guidelines recommend not screening adults with \<10-year life expectancy for cancer; however, primary care physicians feel uncomfortable talking to older adults about prognosis. The investigators aim to determine whether providing PCPs with scripts on patient prognosis and older adults with information on their prognosis would be useful when recommending stopping cancer screening.

Conditions

Cancer Screening

Keywords

Life expectancy; Older adults; Primary care; Cancer screening

Outcome Measures

Primary Outcomes (1)

• Change in Intentions to be Screened for Colorectal Cancer.

  Intentions to be screened was measured in a pretest-survey and again within 2 weeks of a PCP visit using the choice/predisposition scale which is measured from 1-15 on a 15 point scale. A score of 1 means that a person does not intend to be screened. A score of 15 means that the person does intend to be screened. A score of 8 means they are unsure. Scores between 2-7 means the person is leaning towards not being screened. A score of 9-14 means that person is leaning towards being screened. We examined the change in intentions to be screened from pretest to the posttest survey. The mean delta was determined at the time of the post-test survey which was completed within two weeks of the PCP visit.

  2 weeks

Study Arms (1)

Prognosis Information and Provider Scripts

EXPERIMENTAL

Investigators will send the PCP via secure email the patient's prognosis calculated by the Lee-Schonberg index three days before the patient visit. Investigators will also send PCPs information on patient life expectancy from Cho et al.'s US life tables and scripts developed to sensitively include information on patient prognosis when recommending patients stop being screened for cancer. After five of their patients have participated or recruitment goals are met, investigators will ask PCPs to complete a 10 minute web-based questionnaire about their experience.

Other: Prognosis information and Provider Scripts

Interventions

Prognosis information and Provider Scripts OTHER

An individualized report including each patient's prognosis will be calculated by the Lee-Schonberg and will include information on patient life expectancy from Cho et al.'s US life tables. This report will be sent to the PCP three days before the patient visit. Example scripts for PCPs to use with patients when discussing life expectancy and stopping cancer screening will be sent with the patient prognostic information.

Prognosis Information and Provider Scripts

Eligibility Criteria

• Age: 76 Years - 89 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• English-speaking
• Aged 76 to 89 years
• Scheduled for a routine visit or physical with their PCP in the next 3-12 weeks
• Patient aged 76-79 must have a least one Charlson Comorbidity
• Patient must have undergone CRC screening within the last 10 years
• Women only: patient must have undergone mammography screening within the last 3 years

You may not qualify if:

• older adults with dementia
• older adults with a history of colon cancer
• older adults whose last colonoscopy was read as abnormal
• older women who have a history of breast cancer
• older adults whose PCP has already had 5 patients participate in the study
• older women whose last mammogram was read as abnormal

Sponsors & Collaborators

• Beth Israel Deaconess Medical Center: lead
• National Cancer Institute (NCI): collaborator

Study Sites (2)

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

Location

BIDMC Affiliated Physicians Group

Boston, Massachusetts, 02215, United States

Location

Related Publications (1)

• Schonberg MA, Karamourtopoulos M, Jacobson AR, Aliberti GM, Pinheiro A, Smith AK, Davis RB, Schuttner LC, Hamel MB. A Strategy to Prepare Primary Care Clinicians for Discussing Stopping Cancer Screening With Adults Older Than 75 Years. Innov Aging. 2020 Jul 7;4(4):igaa027. doi: 10.1093/geroni/igaa027. eCollection 2020.

  PMID: 32793815 DERIVED

Results Point of Contact

• Title: Mara Schonberg
• Organization: Beth Israel Deaconess Medical Center

mschonbe@bidmc.harvard.edu

16177541414

Study Officials

• Mara A Schonberg, MD, MPH

  Beth Israel Deaconess Medical Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator - Staff Physician

Study Record Dates

• First Submitted: March 9, 2018
• First Posted: March 29, 2018
• Study Start: October 3, 2017
• Primary Completion: October 1, 2019
• Study Completion: October 1, 2021
• Last Updated: January 30, 2024
• Results First Posted: January 30, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)