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Web-based info may not increase cancer screening

By Kerry Grens

NEW YORK (Reuters Health) - Offering women information on colon cancer screening via the web does not get them to take up screening any more effectively than printed materials, according to a new study.

"It's disappointing that the web didn't have more effect," said Dr. David Weinberg of Fox Chase Cancer Center in Philadelphia, the report's lead author.

Although the U.S. Preventive Services Task Force recommends that adults between ages 50 and 75 get screened regularly for colorectal cancer, about 40 percent of people don't follow those guidelines.

To raise awareness of the recommendations and encourage people to go get screened, researchers have developed a variety of approaches, Weinberg said, including videos and printed materials. But none of these "have been tremendously successful," he added.

Dr. Hamant Roy, director of gastroenterology research at NorthShore University HealthSystem in Evanston, Illinois, said one method that has been shown to be effective is simply having doctors spend time with their patients to talk about the cancer tests.

"But one of the issues is they have to see more and more people with less and less time, so it gets really hard to have these discussions with patients," said Roy, who was not involved in the new study.

To see whether the web might provide an easily accessible and inexpensive alternative for getting people to comply with screening recommendations, Weinberg and his colleagues asked 865 women who were coming in for routine gynecology appointments to participate in the study.

Of those, 171 saw their doctor as normal, 349 also received printed materials about colon cancer screening at the time of their visit and 345 were offered access to a web site that contained the same information as the printed matter.

Included in the materials was information about the benefits of screening and harms of going unscreened, as well as background on the various types of colon cancer screen available: a stool test once a year, a sigmoidoscopy every five years or a colonoscopy every 10 years.

All the women were eligible to get screened for colon cancer based on their age and health status.

Four months after the doctor visit, however, roughly 12 percent of the women - regardless of whether they received the extra information or not - had gotten a colon cancer screen.

Roy called the numbers "dismal."

"At the end of the day, something is better than nothing," he said, but compared to screening rates for breast cancer, the uptake for colorectal cancer screening was quite low.

Among the women in the study, published in the Archives of Internal Medicine, 73 percent had received a mammogram in the past year.

On the other hand, Weinberg said, "you might argue their participation in the study did manage to raise their interest level enough" to get screened.

Not enough, however, to get most of the women to even access the website Weinberg's group had developed.

Only 24 percent had logged on, according to the researchers' records, and just 16 percent of the women remembered going to the website.

Weinberg still thinks there might be ways that the web could be helpful.

"I think that the web has great promise...the question is, how do you get people to look at it in the first place?" he said.

Perhaps following up with people to ask them about their experience on the website might improve their participation, he suggested.

Roy agreed that it would be premature to toss out the web as a potential tool for increasing screening rates.

"It seems like the energy to get people over the hump to get colorectal screening is higher than simply passively going to a website. I think the website is maybe helpful, but there needs to be more help to get them over the edge," he said.

SOURCE: http://bit.ly/VizaRR Archives of Internal Medicine, online December 17, 2012.

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