Promoting cancer screening among the first-degree relatives of breast and colorectal cancer patients: The design of two randomized trials

Background. In this paper two large nationwide trials are described, both o f which will test a comparable telephone-based counseling intervention to p romote cancer screening among the first-degree relatives (FDRs) of breast a nd colorectal cancer patients. The unit of randomization will be the family unit of eligible FDRs, Access to FDRs will be obtained from their relative s with cancer. Selected intervention and design issues are reviewed, includ ing how both projects will respond to FDRs who exhibit significant levels o f cancer-specific anxiety or distress and how potential highrisk cancer fam ilies will be accommodated. Methods. Pursuant to the development of both studies, two feasibility surve ys were conducted to determine whether patients would grant access to their FDRs and whether the FDRS identified by these patients would be receptive to the telephone intervention. Results. Approximately 80% (106 of 132) of breast cancer patients agreed to provide access to their eligible FDRs when contacted on-site at participat ing hospitals and clinics, Of those subsequently selected for telephone fol low-up (n = 95 or 90%), 80% (n = 76) were successfully contacted by telepho ne, and of these 97% (n = 74) provided the names and telephone numbers of t heir FDRs, Among colorectal cancer patients contacted on-site (n = 46), 96% (n = 44) agreed to provide access to their FDRs, and of those contacted by telephone (n = 33 or 75%), 91% (n = 30) provided the requested information about their FDRs. Once contacted, 95% of breast cancer FDRs (55 of 58) and 91% of colorectal cancer patients (51 of 56) endorsed the intervention str ategy. Conclusions. It is argued that this intervention, if proven effective, coul d provide an exportable strategy for reaching large numbers of high-risk in dividuals to promote cancer screening. (C)1999 American Health Foundation a nd Academic Press.