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PreView: a Randomized Trial of a Multi-site Intervention in Diverse Primary Care to Increase Rates of Age-Appropriate Cancer Screening

  • Judith WalshEmail author
  • Michael Potter
  • Rene Salazar
  • Elizabeth Ozer
  • Ginny Gildengorin
  • Natasha Dass
  • Lawrence Green
Original Research
  • 19 Downloads

Abstract

Background

Women aged 50–70 should receive breast, cervical (until age 65), and colorectal cancer (CRC) screening; men aged 50–70 should receive CRC screening and should discuss prostate cancer screening (PSA). PreView, an interactive, individually tailored Video Doctor Plus Provider Alert Intervention, adresses all cancers for which average risk 50–70-year-old individuals are due for screening or screening discussion.

Methods

We conducted a randomized controlled trial in 6 clinical sites. Participants were randomized to PreView or a video about healthy lifestyle. Intervention group participants completed PreView before their appointment and their clinicians received a “Provider Alert.” Primary outcomes were receipt of mammography, Pap tests (with or without HPV testing), CRC screening (FIT in last year or colonoscopy in last 10 years), and PSA screening discussion. Additional outcomes included breast, cervical, and CRC screening discussion.

Results

A total of 508 individuals participated, 257 in the control group and 251 in the intervention group. Screening rates were relatively high at baseline. Compared with baseline screening rates, there was no significant increase in mammography or Pap smear screening, and a nonsignificant increase (18% vs 12%) in CRC screening. Intervention participants reported a higher rate of PSA discussion than did control participants (58% vs 36%: P < 0.01). Similar increases were seen in discussions about mammography, cervical cancer, and CRC screening.

Conclusion

In clinics with relatively high overall screening rates at baseline, PreView did not result in significant increases in breast, cervical, or CRC screening. PreView led to an increase in PSA screening discussion. Clinician-patient discussion of all cancer screenings significantly increased, suggesting that interventions like PreView may be most useful when discussion of the pros and cons of screening is recommended and/or with patients reluctant to undergo screening. Future research should investigate PreView’s impact on those who are hesitant or reluctant to undergo screening.

Trial Registration

ClinicalTrials.gov: NCT02264782

KEY WORDS

cancer screening primary care intervention 

Notes

Acknowledgments

The authors would like to acknowledge the clinicians, staff, and patients at our six UCSF Clinical Research Network Sites (John Muir Medical Center – Concord, San Ramon Valley Primary Care (now known as John Muir Health), Family Care Associates, Lifelong Medical Care – West Berkeley, Highland Hospital Adult Medicine Clinic, and Southeast Medical Center) for their enthusiastic participation in the PreView randomized trial.

Funding Information

This study was funded by a grant from the National Cancer Institute (NIH-R01-CA-158027) and is registered with ClinicalTrials.gov (NCT02264782).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_5438_MOESM1_ESM.docx (20 kb)
ESM 1 (DOCX 20.2 kb)

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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Judith Walsh
    • 1
    Email author
  • Michael Potter
    • 2
  • Rene Salazar
    • 3
    • 4
  • Elizabeth Ozer
    • 5
    • 6
  • Ginny Gildengorin
    • 1
  • Natasha Dass
    • 1
  • Lawrence Green
    • 7
  1. 1.Division of General Internal Medicine, Department of Medicine University of California San FranciscoSan FranciscoUSA
  2. 2.Department of Family and Community MedicineUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Department of Medical EducationThe University of Texas at AustinAustinUSA
  4. 4.Department of Internal MedicineThe University of Texas at AustinAustinUSA
  5. 5.Division of Adolescent and Young Adult Medicine, Department of PediatricsUniversity of California, San FranciscoSan FranciscoUSA
  6. 6.Office of Diversity and OutreachUniversity of California, San FranciscoSan FranciscoUSA
  7. 7.Helen Diller Comprehensive Cancer Center and Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA

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