MedicalResearch.com Interview with:
Nathaniel Ernstoff, MD
University of Miami
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population. Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening.
This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer.
Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests. After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions. Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study’s completion.
MedicalResearch.com: What should readers take away from your report?
Response: Everybody has the potential to develop colon cancer, and that risk is about 1 in every 20 individuals. Yes, that means you! Screening can save your life. Currently, there are 6 different screening tests that all have different strengths and weaknesses. These differences are important to understand prior to picking a test that best suits you. This virtual reality demonstration teaches you about your risk, how colon cancer develops, and reviews all of the tests offered to help you have a more meaningful discussion with your provider before making a decision. If you haven’t had a discussion with your healthcare provider about colorectal cancer screening, and you are age 50 or above, or have a family history of colon cancer, please talk to your healthcare provider today.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The next step is to perform the study in additional centers to see if the data can be replicated and then use the demonstration on patients who have just turned 50 and have not been offered screening yet. Ultimately, educational modules such as ours may improve the screening rates across the nation.
Citation: ACG2018 abstract
Nathaniel Ernstoff, MD1, Janelle Cuervo, DO, MS1, Flavia Carneiro, PhD2, Ignacia Dalmacio, ARNP3, Amar Deshpande, MD, FACG1, Daniel A. Sussman, MD, MSPH4, Jamie S. Barkin, MD, MACG4, Paul A. Feldman, MD, MSc4
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