Abstract
Breast cancer survivors are at risk of developing a second primary cancer. Colorectal cancer (CRC) is one of the leading second primary cancers, and it is often preventable. We developed a multi-component educational tool to inform and encourage women breast cancer survivors to engage in CRC screening. To assess the strengths and weakness of the tool and to improve the relevancy to the target audience, we convened four focus groups of women breast cancer survivors in Missouri. We also assessed the potential impact of the tool on the knowledge, attitudes, and beliefs regarding CRC and collected information on the barriers to CRC screening through pre- and post-focus groups’ questionnaires. A total of 43 women breast cancer survivors participated and provided very valuable suggestions on design and content to update the tool. Through the process and comparing pre- and post-focus group assessments, a significantly higher proportion of breast cancer survivors strongly agreed or agreed that CRC is preventable (78.6% vs. 96.9%, p = 0.02) and became aware that they were at a slightly increased risk for CRC (18.6% vs. 51.7%, p = 0.003). The most cited barrier was the complexity of preparation for colonoscopy.
Highlights
Breast cancer survivors, at almost 3 million, comprise the largest group of cancer survivors recorded in surveillance databases in the United States [1]
Screening; the picture depicting a surgical team with mask should be replaced; and the graphic showing the reach of sigmoidoscopy compared to colonoscopy should be defined, softened and shaded
For individuals at average risk beginning at age 50, the ACS recommends several colorectal cancer screening tests and include: FOBT or fecal immunochemical test (FIT) every year; or stool deoxyribonucleic acid (DNA) test every 3 years; or flexible sigmoidoscopy (FSIG) or double-contrast barium enema (DCBE), or computed tomographic colonography (CTC) every 5 years; or colonoscopy every 10 years [49]
Summary
At almost 3 million, comprise the largest group of cancer survivors recorded in surveillance databases in the United States [1]. If detected at an early, localized stage, the five-year relative survival exceeds 98%. Contributing to these milestones are genetic discoveries [2,3,4], advances in screening [5,6] and personalized therapies [7,8,9,10]. Molina-Montes et al conducted a systematic literature review and a separate meta-analysis to evaluate the risk of developing a second primary cancer among female breast cancer survivors. Raymond et al found approximately 12.3% of female breast cancer survivors experience a second primary cancer and this risk varied by age (11.7% diagnosed with breast cancer before age 50 and 17% diagnosed at or after age 50)
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