Baseline Features and Reasons for Nonparticipation in the Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) Study, a Colorectal Cancer Screening Trial.

Autor:	Robertson DJ; VA Medical Center, White River Junction, Vermont.; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire., Dominitz JA; VA Puget Sound Health Care System, Seattle, Washington.; University of Washington School of Medicine, Seattle., Beed A; Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, Connecticut., Boardman KD; Department of Veterans Affairs Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, New Mexico., Del Curto BJ; Department of Veterans Affairs Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, New Mexico., Guarino PD; Statistical Center of HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Center, Seattle, Washington., Imperiale TF; Center for Innovation, Health Services Research and Development, Richard L. Roudebush VA Medical Center and Department of Medicine, Indiana University School of Medicine, Indianapolis., LaCasse A; VA Medical Center, White River Junction, Vermont., Larson MF; VA Puget Sound Health Care System, Seattle, Washington., Gupta S; Section of Gastroenterology, VA San Diego, and Department of Medicine, University of California, San Diego., Lieberman D; Division of Gastroenterology and Hepatology, Portland VA Medical Center, and Oregon Health and Science University, Portland., Planeta B; Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, Connecticut., Shaukat A; New York Harbor VA Healthcare System and New York University Grossman School of Medicine, New York., Sultan S; Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis VA Healthcare System, Minneapolis., Menees SB; Division of Gastroenterology, Department of Internal Medicine, Ann Arbor VA Medical Center, Ann Arbor, Michigan.; Division of Gastroenterology, Michigan Medicine, Ann Arbor., Saini SD; US Department of Veteran Affairs Health Services Research and Development Center for Clinical Management Research, Ann Arbor, Michigan.; Division of Gastroenterology, University of Michigan, Ann Arbor.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor., Schoenfeld P; John D. Dingell VA Medical Center, Atlanta, Georgia., Goebel S; Atlanta VA Medical Center, Decatur, Georgia.; Emory University, Atlanta, Georgia., von Rosenvinge EC; VA Maryland Health Care System, Baltimore.; University of Maryland School of Medicine, Baltimore., Baffy G; Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts., Halasz I; Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts.; Primary Care, West Roxbury, Massachusetts., Pedrosa MC; Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts.; Boston University, Boston, Massachusetts., Kahng LS; Gastroenterology Section, Jesse Brown VA Medical Center, and University of Illinois at Chicago., Cassim R; Louis A. Johnson VA Medical Center, Clarksburg, West Virginia.; Department of Surgery, West Virginia University, Morgantown., Greer KB; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.; Louis Stokes VA Medical Center, Cleveland, Ohio., Kinnard MF; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.; VA Northeast Ohio Healthcare System, Cleveland., Bhatt DB; VA North Texas Health Care Center, University of Texas Southwestern Medical School, Dallas., Dunbar KB; VA North Texas Healthcare System, University of Texas Southwestern, Dallas., Harford WV Jr; VA North Texas Health Care Center, University of Texas Southwestern Medical School, Dallas., Mengshol JA; Division of Gastroenterology and Hepatology University of Colorado School of Medicine, Denver., Olson JE; Rocky Mountain Regional VA Medical Center, University of Colorado Anschutz Medical Center, Aurora., Patel SG; Division of Gastroenterology and Hepatology, Rocky Mountain Regional VA Medical Center, University of Colorado Anschutz Medical Center, Aurora., Antaki F; John D. Dingell VA Medical Center and Wayne State University School of Medicine, Detroit, Michigan., Fisher DA; Durham VA Medical Center, Durham, North Carolina., Sullivan BA; Division of Gastroenterology, Durham VA Medical Center, Durham, North Carolina.; Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina., Lenza C; New Jersey VA Healthcare System, East Orange., Prajapati DN; VA Central California Health Care System, University of California, San Francisco, Fresn., Wong H; VA Central California Health Care System, University of California, San Francisco, Fresn., Beyth R; Department of Medicine, University of Florida, Gainesville., Lieb JG 2nd; Division of Gastroenterology, University of Florida, Gainesville.; Malcolm Randall VA Medical Center, Gainesville, Florida., Manlolo J; VA Pacific Islands Health Care System, Honolulu, Hawaii., Ona FV; University of Hawaii School of Medicine, Honolulu., Cole RA; Department of Gastroenterology, Michael E. DeBakey VA Medical Center, Houston, Texas., Khalaf N; Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas.; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas., Kahi CJ; Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis., Kohli DR; Kansas City VA Medical Center, Kansas City, Missouri.; Providence Sacred Heart Medical Center, Spokane, Washington., Rai T; Borland Groover Clinic, Jacksonville, Florida., Sharma P; Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City.; Division of Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, Missouri., Anastasiou J; Central Arkansas Veterans Healthcare System, Gastroenterology and Hepatology Division, University of Arkansas for Medical Sciences, Little Rock., Hagedorn C; Gastroenterology Division, New Mexico Veterans Healthcare System, and Department of Medicine, University of New Mexico School of Medicine, Albuquerque., Fernando RS; VA Loma Linda Healthcare System, Loma Linda, California.; Department of Medicine, University of California, Riverside., Jackson CS; VA Loma Linda Healthcare System, Loma Linda, California.; Department of Medicine, University of California, Riverside., Jamal MM; Department of Medicine, University of California, Riverside.; Oceana Gastroenterology Associates, Corona, California., Lee RH; VA Long Beach Health Care System, Long Beach, California.; University of California, Irvine., Merchant F; V22 Clinical Resource Hub, Long Beach, California., May FP; Greater Los Angeles VA Healthcare System, Los Angeles, California.; David Geffen School of Medicine at UCLA, Los Angeles, California., Pisegna JR; Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, California.; Departments of Medicine and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California., Omer E; University of Louisville, Louisville, Kentucky.; Robley Rex VA Medical Center, Louisville, Kentucky., Parajuli D; Robley Rex VA Medical Center, Louisville, Kentucky.; Division of Gastroenterology, Hepatology and Nutrition, University of Louisville School of Medicine, Louisville, Kentucky., Said A; William S. Middleton VA Medical Center, Madison, Wisconsin.; Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison., Nguyen TD; Memphis VA Medical Center, Memphis, Tennessee.; University of Tennessee Health Science Center, Memphis., Tombazzi CR; Memphis VA Medical Center, Memphis, Tennessee.; University of Tennessee, Memphis., Feldman PA; Bruce W. Carter VA Medical Center, Miami, Florida., Jacob L; Bruce W. Carter VA Medical Center, Miami, Florida., Koppelman RN; Bruce W. Carter VA Medical Center, Miami, Florida., Lehenbauer KP; Minneapolis VA Healthcare System, Minneapolis, Minnesota., Desai DS; Northport VA Medical Center, State University of New York Stony Brook, Northport., Madhoun MF; Oklahoma City VA Medical Center, Oklahoma City.; Section of Digestive Diseases and Nutrition, Department of Medicine, University of Oklahoma, Oklahoma City., Tierney WM; Oklahoma City VA Medical Center, Oklahoma City., Ho MQ; Department of Infectious Disease, Orlando VA Healthcare System, University of Central Florida, Orlando., Hockman HJ; Malcolm Randall VA Medical Center, Gainesville, Florida., Lopez C; Orlando VA Healthcare System, Orlando, Florida., Carter Paulson E; VA Medical Center, Philadelphia, Pennsylvania.; University of Philadelphia, Philadelphia, Pennsylvania., Tobi M; Department of Research and Development, John D. Dingell VA Medical Center, Detroit, Michigan., Pinillos HL; Phoenix VA Healthcare System, Phoenix, Arizona.; University of Arizona College of Medicine, Phoenix., Young M; New Jersey VA Healthcare System, East Orange., Ho NC; Division of Gastroenterology and Hepatology, Portland VA Medical Center, and Oregon Health and Science University, Portland., Mascarenhas R; Central Texas Veterans Health Care System, Austin Outpatient Clinic, Austin, Texas.; Department of Medicine, Dell Medical School, The University of Texas at Austin., Promrat K; Providence VA Medical Center, Providence, Rhode Island.; The Warren Alpert Medical School of Brown University, Providence, Rhode Island., Mutha PR; McGuire VA Medical Center, Richmond, Virginia; Now with The University of Texas Health Science Center, Houston., Pandak WM Jr; Richmond VA Medical Center, Richmond, Virginia.; Virginia Commonwealth University, Richmond, Virginia., Shah T; Digestive Disease and Surgery Institute, Cleveland Clinic Florida, Weston., Schubert M; Virginia Commonwealth University, Richmond, Virginia.; Central Virginia VA Healthcare System, Richmond., Pancotto FS; Salisbury VA Medical Center, Salisbury, North Carolina.; Wake Forrest University School of Medicine, Winston-Salem, North Carolina., Gawron AJ; Salt Lake City VA Medical Center, Salt Lake City, Utah.; University of Utah, Salt Lake City., Underwood AE; Salt Lake City VA Medical Center, Salt Lake City, Utah., Ho SB; VA Medical Center San Diego, San Diego, California., Magno-Pagatzaurtundua P; Section of Gastroenterology, VA Caribbean Healthcare System, San Juan, Puerto Rico., Toro DH; Section of Gastroenterology, VA Caribbean Healthcare System, San Juan, Puerto Rico., Beymer CH; VA Puget Sound Healthcare System, Seattle, Washington.; University of Washington School of Medicine, Seattle., Kaz AM; University of Washington School of Medicine, Seattle.; Gastroenterology Section, VA Puget Sound Healthcare System, Seattle, Washington., Elwing J; St Louis VA Medical Center, St Louis, Missouri.; Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri., Gill JA; James A. Haley VA Hospital, Tampa, Florida.; University of South Florida College of Medicine, Tampa., Goldsmith SF; James A. Haley VA Hospital, Tampa, Florida., Yao MD; Gastroenterology and Hepatology Section, VA Medical Center, Washington, District of Columbia.; George Washington University School of Medicine and Health Sciences, Washington, District of Columbia., Protiva P; VA Connecticut Healthcare System, West Haven, Connecticut.; Department of Medicine (Digestive Diseases), Yale University School of Medicine, New Haven, Connecticut., Pohl H; VA Medical Center, White River Junction, Vermont.; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire., Kyriakides T; Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, Connecticut.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2023 Jul 03; Vol. 6 (7), pp. e2321730. Date of Electronic Publication: 2023 Jul 03.
DOI:	10.1001/jamanetworkopen.2023.21730
Abstrakt:	Importance: The Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) randomized clinical trial sought to recruit 50 000 adults into a study comparing colorectal cancer (CRC) mortality outcomes after randomization to either an annual fecal immunochemical test (FIT) or colonoscopy. Objective: To (1) describe study participant characteristics and (2) examine who declined participation because of a preference for colonoscopy or stool testing (ie, fecal occult blood test [FOBT]/FIT) and assess that preference's association with geographic and temporal factors. Design, Setting, and Participants: This cross-sectional study within CONFIRM, which completed enrollment through 46 Department of Veterans Affairs medical centers between May 22, 2012, and December 1, 2017, with follow-up planned through 2028, comprised veterans aged 50 to 75 years with an average CRC risk and due for screening. Data were analyzed between March 7 and December 5, 2022. Exposure: Case report forms were used to capture enrolled participant data and reasons for declining participation among otherwise eligible individuals. Main Outcomes and Measures: Descriptive statistics were used to characterize the cohort overall and by intervention. Among individuals declining participation, logistic regression was used to compare preference for FOBT/FIT or colonoscopy by recruitment region and year. Results: A total of 50 126 participants were recruited (mean [SD] age, 59.1 [6.9] years; 46 618 [93.0%] male and 3508 [7.0%] female). The cohort was racially and ethnically diverse, with 748 (1.5%) identifying as Asian, 12 021 (24.0%) as Black, 415 (0.8%) as Native American or Alaska Native, 34 629 (69.1%) as White, and 1877 (3.7%) as other race, including multiracial; and 5734 (11.4%) as having Hispanic ethnicity. Of the 11 109 eligible individuals who declined participation (18.0%), 4824 (43.4%) declined due to a stated preference for a specific screening test, with FOBT/FIT being the most preferred method (2820 [58.5%]) vs colonoscopy (1958 [40.6%]; P < .001) or other screening tests (46 [1.0%] P < .001). Preference for FOBT/FIT was strongest in the West (963 of 1472 [65.4%]) and modest elsewhere, ranging from 199 of 371 (53.6%) in the Northeast to 884 of 1543 (57.3%) in the Midwest (P = .001). Adjusting for region, the preference for FOBT/FIT increased by 19% per recruitment year (odds ratio, 1.19; 95% CI, 1.14-1.25). Conclusions and Relevance: In this cross-sectional analysis of veterans choosing nonenrollment in the CONFIRM study, those who declined participation more often preferred FOBT or FIT over colonoscopy. This preference increased over time and was strongest in the western US and may provide insight into trends in CRC screening preferences.
Databáze:	MEDLINE
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