The Web-Based Randomized Controlled Intervention as the Enhancer of Cancer Prevention
Abstract
:1. Introduction
2. Materials and Methods
2.1. General Description of the Study
2.2. Methods
2.3. Data Analysis
2.4. Ethical Approval
3. Results
4. Discussion
4.1. Limitations of the Study
4.2. The Practical Importance of the Scientific Report
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018, 33, 2597–2604. [Google Scholar] [CrossRef]
- Ferlay, J.; Soerjomataram, I.; Dikshit, R.; Eser, S.; Mathers, C.; Rebelo, M.; Parkin, D.M.; Forman, D.; Bray, F. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer 2015, 136, E359–E386. [Google Scholar] [CrossRef] [PubMed]
- Soerjomataram, I.; de Vries, E.; Pukkala, E.; Coebergh, J.W. Excess of cancers in Europe: A study of eleven major cancers amenable to lifestyle change. Int. J. Cancer 2007, 120, 1336–1343. [Google Scholar] [CrossRef] [PubMed]
- World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective; American Institute for Cancer Research: Washington, DC, USA, 2007. [Google Scholar]
- Quaife, S.; Forbes, L.; Ramirez, A.; Brain, K.; Donnelly, C.; Simon, A.; Wardle, J. Recognition of cancer warning signs and anticipated delay in help-seeking in a population sample of adults in the UK. Br. J. Cancer 2014, 110, 12–18. [Google Scholar] [CrossRef] [PubMed]
- Simon, A.E.; Waller, J.; Robb, K.; Wardle, J. Patient delay in presentation of possible cancer symptoms: The contribution of knowledge and attitudes in a population sample from the United Kingdom. Cancer Epidemiol. Biomark. Prev. 2010, 19, 2272–2277. [Google Scholar] [CrossRef] [PubMed]
- Hvidberg, L.; Pedersen, A.F.; Wulff, C.N.; Vedsted, P. Cancer awareness and socio-economic position: Results from a population-based study in Denmark. BMC Cancer 2014, 14, 581. [Google Scholar] [CrossRef] [PubMed]
- Paddison, J.S.; Yip, M.J. Exploratory study examining barriers to participation in colorectal cancer screening. Aust. J. Rural Health 2010, 18, 11–15. [Google Scholar] [CrossRef]
- American Cancer Society. Cancer Facts Figures 2016; American Cancer Society: Atlanta, GA, USA, 2016. [Google Scholar]
- Katičić, M.; Antoljak, N.; Kujundžić, M.; Stamenić, V.; Skoko Poljak, D.; Kramarić, D.; Stimac, D.; Strnad Pešikan, M.; Samija, M.; Ebling, Z. Results of national colorectal cancer screening program in Croatia (2007–2011). World J. Gastroenterol. 2012, 18, 4300–4307. [Google Scholar] [CrossRef]
- Gimeno-García, A.Z.; Quintero, E.; Nicolás-Pérez, D.; Jiménez-Sosa, A. Public awareness of colorectal cancer and screening in a Spanish population. Public Health 2011, 125, 609–615. [Google Scholar] [CrossRef]
- Armstrong, A.; Powell, C.; Powell, R.; Hallam, N.; Taylor, J.; Bird, J.; Sarran, C.; Oliver, D. Are we seeing the effects of public awareness campaigns? A 10-year analysis of Breslow thickness at presentation of malignant melanoma in the South West of England. J. Plast. Reconstr. Aesthet. Surg. 2014, 67, 324–330. [Google Scholar] [CrossRef]
- Kaminski, M.F.; Wieszczy, P.; Rupinski, M.; Wojciechowska, U.; Didkowska, J.; Kraszewska, E.; Kobiela, J.; Franczyk, R.; Rupinska, M.; Kocot, B.; et al. Increased rate of adenoma detection associates with reduced risk of colorectal cancer and death. Gastroenterology 2017, 153, 98–105. [Google Scholar] [CrossRef] [PubMed]
- Rees, C.J.; Bevan, R.; Zimmermann-Fraedrich, K.; Rutter, M.D.; Rex, D.; Dekker, E.; Ponchon, T.; Bretthauer, M.; Regula, J.; Saunders, B.; et al. Expert opinions and scientific evidence for colonoscopy key performance indicators. Gut 2016, 65, 2045–2060. [Google Scholar] [CrossRef] [PubMed]
- Bender, J.L.; Wiljer, D.; To, M.J.; Bedard, P.L.; Chung, P.; Jewett, M.A.S.; Matthew, A.; Moore, M.; Warde, P.; Gospodarowicz, M. Testicular cancer survivors’ supportive care needs and use of online support: A cross-sectional survey. Support. Care Cancer 2012, 20, 2737–2746. [Google Scholar] [CrossRef] [PubMed]
- Wiljer, D.; Urowitz, S.; Barbera, L.; Chivers, M.L.; Quartey, N.K.; Ferguson, S.E.; To, M.; Classen, C.C. A Qualitative study of an internet-based support group for women with sexual distress due to gynecologic cancer. J. Cancer Educ. 2011, 26, 451–458. [Google Scholar] [CrossRef] [PubMed]
- Gajda, M.; Kowalska, M. Internet in interventional studies on cancer prevention (in Polish). Hygeia Public Health 2016, 51, 115–123. [Google Scholar]
- Gajda, M.; Kowalska, M.; Zejda, J.E. Evaluation of the first Polish web-based intervention aimed at improving cancer prevention (the PORINA Study). Int. J. Environ. Res. Public Health 2018, 15, 1167. [Google Scholar] [CrossRef] [PubMed]
- Schüz, J.; Espina, C.; Villain, P.; Herrero, R.; Leon, M.E.; Minozzi, S.; Romieu, I.; Segnan, N.; Wardle, J.; Wiseman, M.; et al. European Code against Cancer 4th Edition: 12 ways to reduce your cancer risk. Cancer Epidemiol. 2015, 39, S1–S10. [Google Scholar] [CrossRef]
- R Core Team. A Language and Environment for Statistical Computing. Available online: http://cran.r-project.org (accessed on 2 May 2016).
- Hvidberg, L.; Wulff, C.N.; Pedersen, A.F.; Vedsted, P. Barriers to healthcare seeking, beliefs about cancer and the role of socio-economic position: A Danish population-based study. Prev. Med. 2015, 71, 107–113. [Google Scholar] [CrossRef]
- Al-Azri, M.; Al-Hamedi, I.; Al-Awisi, H.; Al-Hinai, M.; Davidson, R. Public awareness of warning signs and symptoms of cancer in Oman: A community-based survey of adults. Asian Pac. J. Cancer Prev. 2015, 16, 2731–2737. [Google Scholar] [CrossRef]
- Niksic, M.; Rachet, B.; Duffy, S.W.; Quaresma, M.; Møller, H.; Forbes, L.J. Is cancer survival associated with cancer symptom awareness and barriers to seeking medical help in England? An ecological study. Br. J. Cancer 2016, 115, 876–886. [Google Scholar] [CrossRef] [Green Version]
- Bowen, D.J.; Robbins, R.; Bush, N.; Meischke, H.; Ludwig, A.; Wooldridge, J. Effects of a web-based intervention on women’s breast health behaviors. Transl. Behav. Med. 2011, 1, 155–164. [Google Scholar] [CrossRef]
- Lairson, D.R.; Chung, T.H.; Smith, L.G.; Springston, J.K.; Champion, V.L. Estimating development cost of an interactive website based cancer screening promotion program. Eval. Program. Plann. 2015, 50, 56–62. [Google Scholar] [CrossRef] [Green Version]
- Marek, E.; Dergez, T.; Rebek-Nagy, G.; Szilard, I.; Kiss, I.; Ember, I.; Gocze, P.; D’Cruz, G. Effect of an educational intervention on Hungarian adolescents awareness, beliefs and attitudes on the prevention of cervical cancer. Vaccine 2012, 30, 6824–6832. [Google Scholar] [CrossRef]
- Steckelberg, A.; Hülfenhaus, C.; Haastert, B.; Mühlhauser, I. Effect of evidence based risk information on informed choice in colorectal cancer screening: Randomised controlled trial. BMJ 2011, 342, d3193. [Google Scholar] [CrossRef]
- Brackett, C.D.; Kearing, S. Use of a web-based survey to facilitate shared decision making for patients eligible for cancer screening. Patient 2015, 8, 171–177. [Google Scholar] [CrossRef]
- National Cancer Institute Health Information National Trends Survey. Available online: http://hints.cancer.gov (accessed on 31 Janruary 2018).
Group | ||||||
---|---|---|---|---|---|---|
Quantitative Variables (Median and IQR in the Bracket) | Control | Intervention | p | |||
n = 256 | n = 207 | |||||
Age (years) | 31 (22–47) | 35 (21–47) | 0.9 a | |||
Baseline CKI | 14 (12–16) | 14 (11–16) | 0.2 a | |||
Final CKI | 14 (12–16) | 17 (15–18) | <0.001 a | |||
Categorical variables (%) | ||||||
Gender | Male | 39.1 | 38.2 | 0.8 b | ||
Female | 60.9 | 61.8 | ||||
Place of residence with the number of inhabitants | Villages | 23.4 | 19.8 | 0.6 b | ||
Cities | ≤100,000 | 25.0 | 25.6 | |||
>100,000 | 51.6 | 54.6 | ||||
Level of education | Primary | 4.7 | 8.2 | 0.2 b | ||
Secondary | 36.3 | 35.7 | ||||
High school | 51.2 | 51.7 | ||||
Higher medical | 7.8 | 4.3 | ||||
Occupation | Other | 84.0 | 83.6 | 0.9 b | ||
Medical | 16.0 | 16.4 | ||||
Positive family history of cancer | overall | No | 23.8 | 28.5 | 0.3 b | |
Yes | 76.2 | 71.5 | ||||
parents | No | 70.3 | 73.9 | 0.4 b | ||
Yes | 29.7 | 26.1 | ||||
grandparents | No | 55.1 | 52.7 | 0.6 b | ||
Yes | 44.9 | 47.3 | ||||
siblings | No | 94.1 | 96.1 | 0.4 b | ||
Yes | 5.9 | 3.9 | ||||
Diagnosis of cancer | No | 87.9 | 90.8 | 0.4 b | ||
Yes | 12.1 | 9.2 | ||||
Treated oncologically | No | 89.5 | 89.9 | 1 b | ||
Yes | 10.5 | 10.1 | ||||
Self-declaration of sufficient cancer-related level of knowledge | No | 78.5 | 77.8 | 0.9 b | ||
Yes | 21.5 | 22.2 | ||||
Self-declaration of willingness to improve the level of cancer-related knowledge | No | 7.8 | 7.2 | 0.9 b | ||
Yes | 92.2 | 92.8 |
A. Potential Agreement (%) Depending on Baseline CKI Value | ||||||||
---|---|---|---|---|---|---|---|---|
Medical Procedure | Overall | Low | Medium | High | p * | |||
(n = 107) | (n = 234) | (n = 122) | ||||||
Breast Fine Needle Aspiration | 81.9 | 64.5 | 84.2 | 92.6 | <0.001 | |||
Abdominal ultrasonography | 98.1 | 95.3 | 98.3 | 100 | <0.05 | |||
Mammography | 88.1 | 82.2 | 86.8 | 95.9 | <0.001 | |||
Digital Rectal Examination | 79.0 | 61.7 | 81.2 | 90.2 | <0.001 | |||
Colonoscopy | 85.7 | 69.2 | 88.9 | 94.3 | <0.001 | |||
Bronchoscopy | 82.3 | 67.3 | 84.6 | 91.0 | <0.001 | |||
Gastroscopy | 85.3 | 72.0 | 87.6 | 92.6 | <0.001 | |||
Removal of a nevi from the skin | 89.8 | 74.8 | 92.7 | 97.5 | <0.001 | |||
Computed Tomography | 98.5 | 97.2 | 98.3 | 100 | NS | |||
Surgical procedure with possible artificial anus | 47.3 | 29.0 | 51.3 | 55.7 | <0.001 | |||
B. Potential Agreement (%) Depending on Study Group | ||||||||
Medical Procedure | Intervention | p ** | Control | p ** | ||||
Initial | Final | Change | Initial | Final | Change | |||
Breast Fine Needle Aspiration | 81.2 | 87.4 | 6.2 | <0.05 | 82.4 | 82.8 | 0.4 | NS |
Abdominal ultrasonography | 98.1 | 99.0 | 0.9 | NS | 98.0 | 99.2 | 1.2 | NS |
Mammography | 86.5 | 92.8 | 6.3 | <0.01 | 89.5 | 91.4 | 1.9 | NS |
Digital Rectal Examination | 76.3 | 80.7 | 4.4 | NS | 81.2 | 82.0 | 0.8 | NS |
Colonoscopy | 83.6 | 86.5 | 2.9 | NS | 87.5 | 87.5 | 0.0 | NS |
Bronchoscopy | 80.2 | 84.5 | 4.3 | NS | 84.0 | 84.8 | 0.8 | NS |
Gastroscopy | 83.6 | 88.4 | 4.8 | <0.05 | 86.7 | 88.3 | 1.6 | NS |
Removal of a nevi from the skin | 87.4 | 88.9 | 1.5 | NS | 91.8 | 93.8 | 2.0 | NS |
Computed Tomography | 98.1 | 97.6 | −0.5 | NS | 98.8 | 98.0 | −0.8 | NS |
Surgical procedure with possible artificial anus | 44.9 | 49.3 | 4.4 | NS | 49.2 | 48.4 | −0.8 | NS |
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Gajda, M.; Kowalska, M. The Web-Based Randomized Controlled Intervention as the Enhancer of Cancer Prevention. Medicina 2019, 55, 434. https://doi.org/10.3390/medicina55080434
Gajda M, Kowalska M. The Web-Based Randomized Controlled Intervention as the Enhancer of Cancer Prevention. Medicina. 2019; 55(8):434. https://doi.org/10.3390/medicina55080434
Chicago/Turabian StyleGajda, Maksymilian, and Małgorzata Kowalska. 2019. "The Web-Based Randomized Controlled Intervention as the Enhancer of Cancer Prevention" Medicina 55, no. 8: 434. https://doi.org/10.3390/medicina55080434