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Saya S, Boyd L, Chondros P, McNamara M, King M, Milton S, Lourenco RDA, Clark M, Fishman G, Marker J, Ostroff C, Allman R, Walter FM, Buchanan D, Winship I, McIntosh J, Macrae F, Jenkins M, Emery J. The SCRIPT trial: study protocol for a randomised controlled trial of a polygenic risk score to tailor colorectal cancer screening in primary care. Trials 2022; 23:810. [PMID: 36163034 PMCID: PMC9513012 DOI: 10.1186/s13063-022-06734-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Polygenic risk scores (PRSs) can predict the risk of colorectal cancer (CRC) and target screening more precisely than current guidelines using age and family history alone. Primary care, as a far-reaching point of healthcare and routine provider of cancer screening and risk information, may be an ideal location for their widespread implementation. Methods This trial aims to determine whether the SCRIPT intervention results in more risk-appropriate CRC screening after 12 months in individuals attending general practice, compared with standard cancer risk reduction information. The SCRIPT intervention consists of a CRC PRS, tailored risk-specific screening recommendations and a risk report for participants and their GP, delivered in general practice. Patients aged between 45 and 70 inclusive, attending their GP, will be approached for participation. For those over 50, only those overdue for CRC screening will be eligible to participate. Two hundred and seventy-four participants will be randomised to the intervention or control arms, stratified by general practice, using a computer-generated allocation sequence. The primary outcome is risk-appropriate CRC screening after 12 months. For those in the intervention arm, risk-appropriate screening is defined using PRS-derived risk; for those in the control arm, it is defined using family history and national screening guidelines. Timing, type and results of the previous screening are considered in both arms. Objective health service data will capture screening behaviour. Secondary outcomes include cancer-specific worry, risk perception, predictors of CRC screening behaviour, screening intentions and health service use at 1, 6 and 12 months post-intervention delivery. Discussion This trial aims to determine whether a PRS-derived personalised CRC risk estimate delivered in primary care increases risk-appropriate CRC screening. A future population risk-stratified CRC screening programme could incorporate risk assessment within primary care while encouraging adherence to targeted screening recommendations. Trial registration Australian and New Zealand Clinical Trial Registry ACTRN12621000092897p. Registered on 1 February 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06734-7.
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Affiliation(s)
- Sibel Saya
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia. .,Centre for Cancer Research, University of Melbourne, Melbourne, Australia.
| | - Lucy Boyd
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.,Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Patty Chondros
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia
| | - Mairead McNamara
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.,Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Michelle King
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.,Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Shakira Milton
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.,Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | | | - George Fishman
- Consumer Advisory Group, Primary Care Collaborative Cancer Clinical Trials Group, Carlton, Australia
| | - Julie Marker
- Consumer Advisory Group, Primary Care Collaborative Cancer Clinical Trials Group, Carlton, Australia
| | - Cheri Ostroff
- Centre for Workplace Excellence, University of South Australia, Adelaide, Australia
| | - Richard Allman
- Genetic Technologies/Phenogen Sciences, Fitzroy, Australia.,Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - Fiona M Walter
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.,Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Daniel Buchanan
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia.,Department of Clinical Pathology, University of Melbourne, Melbourne, Australia
| | - Ingrid Winship
- Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Australia.,Genetic Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | - Jennifer McIntosh
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.,HumaniSE Lab, Department of Software Systems and Cybersecurity, Monash University, Clayton, Australia
| | - Finlay Macrae
- Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Australia.,Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Australia
| | - Mark Jenkins
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - Jon Emery
- Primary Care Cancer Research Group, Department of General Practice, Centre for Cancer Research, The University of Melbourne, Victorian Comprehensive Cancer Centre, Level 10, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.,Centre for Cancer Research, University of Melbourne, Melbourne, Australia
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