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T1 COLORECTAL CANCER PATIENTS’ PERSPECTIVE ON INFORMATION PROVISION AND THERAPEUTIC DECISION-MAKING AFTER LOCAL RESECTION

Nik Dekkers 1, Richard Dang 1, Manon de Graaf 1, Kate Nobbenhuis 1, jolein van der Kraan 1, Wouter De Vos Tot Nederveen Cappel 2, Alaa Alkhalaf 2, Erik Van Westreenen 2, Kirill Basiliya 1, Koen C. M. J. Peeters 1, Marinke Westerterp 3, Pascal G. Doornebosch 4, James Hardwick 1, Alexandra Langers 1, Jurjen J. Boonstra 1

Affiliations

1 Leiden University Medical Center, Leiden, Netherlands

2 Isala Clinics, Zwolle, Netherlands

3 Haaglanden Medical Center, The Hague, Netherlands

4 IJsselland Hospital, Capelle aan den IJssel, Netherlands

Summary

AI Generated

In a cross-sectional study of 98 early-stage colorectal cancer patients, higher educated patients were more likely to be actively involved in treatment decisions and to undergo additional treatment, though decisional satisfaction was similar across education levels.

Among 45 high-risk T1CRC patients, 60% reported active involvement in deciding between additional treatment or close monitoring, while 40% reported passive involvement.
Higher educated patients were more likely to report active decision-making involvement compared to lower educated patients (92.9% vs. 43.3%, p=0.002) and to undergo additional treatment (78.6% vs. 40%, p=0.02).
Satisfaction with how the treatment decision was made did not differ between higher and lower educated patients (83 vs. 85.1, p=0.78).
Prevention and post-treatment care were the most common areas where patients expressed unmet information needs.
Patients with high-risk T1CRC reported receiving more information than low-risk patients, though the need for more information was similar between groups (p=0.31).

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Abstract

Introduction

Early-stage colorectal cancer (T1CRC) patients are confronted with complex medical information and considerations throughout the course of their treatment. This study explored patients’ perspective on information provision and therapeutic decision-making.

Aims & Methods

Patients who underwent endoscopic or local surgical resection for T1CRC were eligible for participation in this cross-sectional multicenter study. Information provision was evaluated using the EORTC QLQ-INFO25 questionnaire (INFO25)(1). In patients with a high-risk T1CRC we additionally evaluated patients’ perception of involvement in decision-making regarding the choice to opt for or refrain from additional treatment after local resection, and the degree of decisional conflict using the decision conflict scale (DCS)(2).

Results

In the 98 responders (response rate: 71.5%), patients with high-risk T1CRC (n=45) reported to have received more information on multiple disease aspects compared to patients with low-risk T1CRC (n=53). However, the need for more information was not significantly different between both groups (p=0.31). Overall, 29 patients expressed a need for more information, with ‘prevention’ and ‘post-treatment care’ reported as the most common areas with unmet information needs. Of the 45 patients with high-risk T1CRC, 24 (53.3%) underwent additional treatment, whereas 21 (46.7%) opted for close monitoring. Twenty-seven patients (60%) reported that they were actively involved in this decision (i.e. ‘I made the decision myself’), while 18 patients (40%) reported to be passively involved (i.e. ‘I let my physician make the decision’ or ‘I didn't feel like there was a choice’). Satisfaction scores regarding information provision were similar between patients that underwent additional treatment or opted for close monitoring (range 0-100, 70.8 vs. 73.0, p=0.77). Higher educated patients were more likely to report active involvement in therapeutic decision-making compared to lower educated patients (92.9% vs. 43.3%, p=0.002) and to eventually undergo additional treatment (78.6% vs. 40%, p=0.02). The satisfaction scores regarding how the treatment decision was made did not differ significantly between patients with higher and lower levels of education (range 0-100, 83 vs. 85.1, p=0.78).

Conclusion

From the T1CRC patient’s perspective, this study found that higher educated patients were more likely to be actively involved in therapeutic decision-making than lower educated patients, although decisional satisfaction was irrespective of educational level. With respect to information needs, patients expressed a desire for more information on disease prevention and post-treatment care.

References

1. Arraras JI, Greimel E, Sezer O, Chie W-C, Bergenmar M, Costantini A, et al. An international validation study of the EORTC QLQ-INFO25 questionnaire: An instrument to assess the information given to cancer patients. European Journal of Cancer. 2010;46(15):2726-38.
2. O'Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25-30.

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Quiet quitting in nursing and healthcare professions

Gerlinde Weilguny-Schoefl 1

Affiliations

1 Allg. Krankenhaus Wien Abt. für Innere Medizin Abt. Endoskopie, Wien, Austria

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Abstract

Event

UEG Week Vienna 2024

Topics

Nurses

Session

Management: Increase staff wellbeing

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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Follow-up presentation

Roel Hompes 1

Affiliations

1 Amsterdam UMC, Amsterdam, Netherlands

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Abstract

Event

UEG Postgraduate Teaching Programme 2023

Topics

Digestive Oncology

Session

Advanced colorectal cancer

Published

2023

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Yutaka Saito 1

Affiliations

1 National Cancer Center Hospital Endoscopy Division, Tokyo, Japan

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Abstract

Event

UEG Week Copenhagen 2023

Topics

Colorectal Digestive Oncology Endoscopy Surgery

Session

Early colorectal cancer

Published

2023

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T1b cancer: Only endoscopic treatment?

Federico Barbaro 1

Affiliations

1 Gemelli Hospital, Roma, Italy

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Abstract

Event

UEG Week Copenhagen 2023

Session

What's new in 2023? Organ-sparing treatment for upper GI cancer

Published

2023

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HIGH-RISK POLYPS AND COLORECTAL CANCER IN PATIENTS WITH HEREDITARY DIFFUSE GASTRIC CANCER

Sofia Ventura 1, Jéssica Chaves 2, Ana Clara Vasconcelos 2, Raquel Ortigão 2, Mario Dinis-Ribeiro 2, Catarina Lopes Brandão 2

Affiliations

1 Centro Hospitalar Tondela-Viseu, Viseu, Portugal

2 Ipo Porto, Porto, Portugal

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Abstract

Introduction

CDH1 gene mutations are associated with gastric and breast cancer. The risk of colorectal cancer may be increased in the presence of this mutation, although evidence is scarce.

Aims & Methods

Aims: To assess the presence of high-risk colorectal polyps (polyp with ≥10mm or with high-grade dysplasia, ≥5 adenomas, any serrated polyp ≥10mm or with dysplasia) and colorectal cancer in patients on surveillance program with mutation in CDH1 gene.
Methods: Retrospective study in patients with CDH1 gene mutation followed in a family risk appointment in a tertiary care hospital.

Results

Data from 36 patients with a mean age of 44.22±14.77 years, 20 males, with a mean follow-up of 5.5 years. Twenty-seven patients had family history of gastric cancer and 9 of gastric and breast cancer; twelve patients had never undergone colonoscopy (age ≤ 40 years). Of the 24 patients who had already undergone at least one colonoscopy, 12 (50%) never removed polyps. Only 4 patients had high-risk polyps (age 30, 52, 59 and 77 years) and no patient presented with colorectal cancer during follow-up.

Conclusion

Although this is a small sample, our study revealed a low percentage of patients with hereditary diffuse gastric cancer with high-risk colorectal polyps (and only one patient with a high-risk polyp aged <50 years) and no patients with colorectal cancer, similar to a population without a CDH1 mutation. Further studies with larger sample sizes are needed to clarify the impact of CDH1 mutation on colorectal cancer.

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Federico Barbaro

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UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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Image-guided surgery techniques

Mahdi Al-Taher 1

Affiliations

1 Maastricht UMC, Dubai, United Arab Emirates

Summary

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Abstract

Event

UEG Week Copenhagen 2023

Topics

Endoscopy Mechanisms & Personalised Medicine Radiology & Imaging Surgery

Session

Digestive diseases: Help from the machines?

Published

2023

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