Center of Excellence in Cancer Communication Research, Annenberg School for Communication,University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA19104, USA.
Oncologist. 2012;17(9):1155-62. doi: 10.1634/theoncologist.2012-0173. Epub 2012 Aug 2.
Introduction. Follow-up surveillance after curative treatment for colorectal cancer (CRC) patients is recommended to detect early cancer recurrences and improve survival outcomes. However, a substantial proportion of CRC patients do not undergo cancer surveillance. Several demographic and disease-related factors have been associated with cancer surveillance adherence. Thus far, patient-centered communication has not been studied as a determinant for undergoing cancer surveillance. The purpose of this study is to determine whether patient-clinician information engagement (PCIE) influences patients' self-reported adherence to recommended CRC surveillance procedures. Methods. The study was a longitudinal survey among Pennsylvanian patients diagnosed with CRC in 2005. CRC patients who were eligible for surveillance and participated in both the baseline and 1-year follow-up surveys were included in this analysis (n = 305). The main outcome measure was self-reported adherence to physical examination, carcinoembryonic antigen testing, and colonoscopy according to recommended guidelines. Results. Controlling for potential confounders, higher PCIE at baseline predicted a higher odds for CRC patients reporting adherence to recommended surveillance 1 year later by 2.8 times. Other significant predictors of adhering to recommended surveillance were a higher education level and having received systemic therapy. Discussion. In this longitudinal study among CRC patients who received curative treatment, greater patient engagement with clinicians about cancer-related information was found to improve patients' subsequent adherence to recommended surveillance. This finding provides support for encouraging greater patient-physician communication among CRC patients.
简介。建议对接受结直肠癌(CRC)治愈性治疗的患者进行随访监测,以发现早期癌症复发并改善生存结果。然而,相当一部分 CRC 患者未进行癌症监测。一些人口统计学和疾病相关因素与癌症监测依从性有关。迄今为止,以患者为中心的沟通尚未被视为进行癌症监测的决定因素。本研究旨在确定患者-临床医生信息参与(PCIE)是否会影响患者自我报告的对推荐的 CRC 监测程序的依从性。
方法。本研究是宾夕法尼亚州 2005 年诊断为 CRC 的患者的纵向调查。符合监测条件并参加基线和 1 年随访调查的 CRC 患者被纳入本分析(n=305)。主要观察指标是根据推荐指南自我报告对体格检查、癌胚抗原检测和结肠镜检查的依从性。
结果。控制潜在混杂因素后,基线时更高的 PCIE 预测 CRC 患者报告 1 年后遵医嘱进行监测的可能性增加 2.8 倍。其他显著预测因素包括更高的教育水平和接受过系统治疗。
讨论。在这项接受治愈性治疗的 CRC 患者的纵向研究中,发现与临床医生就癌症相关信息进行更多的患者参与可提高患者随后对推荐监测的依从性。这一发现为鼓励 CRC 患者之间进行更多的医患沟通提供了支持。