{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:07:02Z","timestamp":1788869222790,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,5,20]],"date-time":"2015-05-20T00:00:00Z","timestamp":1432080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"ZonMw \u00e2\u20ac\u201c the Netherlands Organization for Health Research and Development","award":["80-82315-98-09005"],"award-info":[{"award-number":["80-82315-98-09005"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      Only 12\u201349% of colorectal cancer (\n                      <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content>\n                      ) patients and their first\u2010degree relatives with an increased familial\n                      <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content>\n                      risk are referred for cancer prevention measures (surveillance colonoscopies or genetic counselling). The study was performed to evaluate the effectiveness and feasibility of a novel strategy to improve the uptake of genetic counselling for high risk individuals and surveillance colonoscopy for moderate risk groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Eighteen hospitals participated in a clustered randomized controlled trial. Patients in nine hospitals received usual care (group A). Nine other hospitals received the novel strategy (group B) including access to a website for patients and clinicians, patient\u2010targeted brochures and clinician\u2010targeted education and pocket referral cards. Data before and after dissemination of the strategy were collected from questionnaires and medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data were complete for 358 (44%) of 820\n                      <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content>\n                      patients and 50 (36%) of 137 clinicians before dissemination of the strategy and 392\/862 patients (45%) and 47\/137 clinicians (34%) after. Referral for cancer prevention measures was assessed at a median of 8 (2\u201312) months after\n                      <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content>\n                      diagnosis in groups A and B before the dissemination of the strategy and in group A after. In group B referral was assessed at a median of 9 (4\u201311) months after the dissemination of the strategy. Uptake of genetic counselling by high risk patients was equal in groups A and B, being 33% before and 15% after (\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a00.003). Uptake of surveillance colonoscopy by moderate risk relatives did not change significantly (group A, 36% before\n                      <jats:italic>vs<\/jats:italic>\n                      41% after; group B, 33% before\n                      <jats:italic>vs<\/jats:italic>\n                      19% after). In group B 94\/140 patients (67%) and 25\/72 clinicians (35%) visited the website and 34\/140 (24%) patients read the brochure. Patients valued clinicians' information as most useful, followed by the patient brochure. Clinicians preferred pocket cards and education.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our strategy did not improve referral for cancer prevention measures. Although the newly offered strategy elements were appreciated, patients preferred clinicians' advice regarding referral for cancer prevention measures. It may be useful to aim future interventions at healthcare professionals rather than patients to improve the prevention of familial cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.12880","type":"journal-article","created":{"date-parts":[[2014,12,19]],"date-time":"2014-12-19T05:56:28Z","timestamp":1418968588000},"page":"499-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Improving recognition and referral of patients with an increased familial risk of colorectal cancer: results from a randomized controlled trial"],"prefix":"10.1111","volume":"17","author":[{"given":"N.","family":"Dekker","sequence":"first","affiliation":[{"name":"Scientific Institute for Quality of Healthcare Radboud University Medical Centre Nijmegen The Netherlands"},{"name":"Department of Human Genetics Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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A.","family":"van Zelst\u2010Stams","sequence":"additional","affiliation":[{"name":"Department of Human Genetics Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hoogerbrugge","sequence":"additional","affiliation":[{"name":"Department of Human Genetics Radboud University Medical Centre Nijmegen The Netherlands"},{"name":"Department of Medical Oncology Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the RISCO study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38606.794560.EB"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(00)70168-5"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-009-9281-5"},{"key":"e_1_2_9_5_1","volume-title":"Guideline Hereditary Colorectal Cancer","author":"Genetics DSfC","year":"2008"},{"issue":"4","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1093\/annonc\/mdp127","article-title":"Familial colorectal cancer risk: ESMO clinical recommendations","volume":"20","author":"Vasen HF","year":"2009","journal-title":"Ann Oncol"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1119626"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.179804"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2003.50044"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-008-9345-x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-006-9114-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00352-0"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.01898.x"},{"key":"e_1_2_9_14_1","first-page":"124","article-title":"Kruyt M [Inadequate referral for genetic evaluations of patients with colorectal carcinoma]","volume":"153","author":"Staal\u2010Rosier PM","year":"2009","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2004.tb05948.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-6"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12117"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2010.04.034"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20070056"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(98)00026-3"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38926.629329.AE"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.039123"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-199705000-00010"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c5370"},{"key":"e_1_2_9_25_1","unstructured":"Edelman Health Barometer 2011. 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