Improving Internal Medicine Residents’ Colorectal Cancer Screening Knowledge Using a Smartphone App: Pilot Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Colorectal cancer (CRC) is the third most common type of cancer and the second leading cause of cancer death in the United States. About one in three adults in the United States is not getting the CRC screening as recommended. Internal medicine residents are deficient in CRC screening knowledge.

Objective

The objective of our study was to assess the improvement in internal medicine residents’ CRC screening knowledge via a pilot approach using a smartphone app.

Methods

We designed a questionnaire based on the CRC screening guidelines of the American Cancer Society, American College of Gastroenterology, and US Preventive Services Task Force. We emailed the questionnaire via a SurveyMonkey link to all the residents of an internal medicine department to assess their knowledge of CRC screening guidelines. Then we designed an educational intervention in the form of a smartphone app containing all the knowledge about the CRC screening guidelines. The residents were introduced to the app and asked to download it onto their smartphones. We repeated the survey to test for changes in the residents’ knowledge after publication of the smartphone app and compared the responses with the previous survey. We applied the Pearson chi-square test and the Fisher exact test to look for statistical significance.

Results

A total of 50 residents completed the first survey and 41 completed the second survey after publication of the app. Areas of CRC screening that showed statistically significant improvement ( P<.05) were age at which CRC screening was started in African Americans, preventive tests being ordered first, identification of CRC screening tests, identification of preventive and detection methods, following up positive tests with colonoscopy, follow-up after colonoscopy findings, and CRC surveillance in diseases.

Conclusions

In this modern era of smartphones and gadgets, developing a smartphone-based app or educational tool is a novel idea and can help improve residents’ knowledge about CRC screening.

Related collections

Most cited references 21

Record: found
Abstract: found
Article: not found

Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.

Kirsten Bibbins-Domingo, David Grossman, Susan Curry … (2016)

Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years.

0 comments Cited 654 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected].

Douglas Rex, David Johnson, Joseph Anderson … (2009)

This document is the first update of the American College of Gastroenterology (ACG) colorectal cancer (CRC) screening recommendations since 2000. The CRC screening tests are now grouped into cancer prevention tests and cancer detection tests. Colonoscopy every 10 years, beginning at age 50, remains the preferred CRC screening strategy. It is recognized that colonoscopy is not available in every clinical setting because of economic limitations. It is also realized that not all eligible persons are willing to undergo colonoscopy for screening purposes. In these cases, patients should be offered an alternative CRC prevention test (flexible sigmoidoscopy every 5-10 years, or a computed tomography (CT) colonography every 5 years) or a cancer detection test (fecal immunochemical test for blood, FIT).

0 comments Cited 278 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer.

Douglas J Robertson, David R. Lieberman, Theodore R Levin … (2017)

This document updates the colorectal cancer (CRC) screening recommendations of the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy. CRC screening tests are ranked in 3 tiers based on performance features, costs, and practical considerations. The first-tier tests are colonoscopy every 10 years and annual fecal immunochemical test (FIT). Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered. Thus, in a sequential approach based on colonoscopy offered first, FIT should be offered to patients who decline colonoscopy. Colonoscopy and FIT are recommended as tests of choice when multiple options are presented as alternatives. A risk-stratified approach is also appropriate, with FIT screening in populations with an estimated low prevalence of advanced neoplasia and colonoscopy screening in high prevalence populations. The second-tier tests include CT colonography every 5 years, the FIT-fecal DNA test every 3 years, and flexible sigmoidoscopy every 5 to 10 years. These tests are appropriate screening tests, but each has disadvantages relative to the tier 1 tests. Because of limited evidence and current obstacles to use, capsule colonoscopy every 5 years is a third-tier test. We suggest that the Septin9 serum assay (Epigenomics, Seattle, Wash) not be used for screening. Screening should begin at age 50 years in average-risk persons, except in African Americans in whom limited evidence supports screening at 45 years. CRC incidence is rising in persons under age 50, and thorough diagnostic evaluation of young persons with suspected colorectal bleeding is recommended. Discontinuation of screening should be considered when persons up to date with screening, who have prior negative screening (particularly colonoscopy), reach age 75 or have <10 years of life expectancy. Persons without prior screening should be considered for screening up to age 85, depending on age and comorbidities. Persons with a family history of CRC or a documented advanced adenoma in a first-degree relative age <60 years or 2 first-degree relatives with these findings at any age are recommended to undergo screening by colonoscopy every 5 years, beginning 10 years before the age at diagnosis of the youngest affected relative or age 40, whichever is earlier. Persons with a single first-degree relative diagnosed at ≥60 years with CRC or an advanced adenoma can be offered average-risk screening options beginning at age 40 years.

0 comments Cited 238 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Zubair Khan:

Department of Internal MedicineUniversity of Toledo Medical Center3000 Arlington AvenueToledo, OH, 43614United States1 4193834000zubair.khan@utoledo.edu

ORCID: http://orcid.org/0000-0001-5732-7678

Journal

Journal ID (nlm-ta): JMIR Med Educ

Journal ID (iso-abbrev): JMIR Med Educ

Journal ID (publisher-id): JME

Title: JMIR Medical Education

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2369-3762

Publication date Collection: Jan-Jun 2018

Publication date (Electronic): 13 March 2018

Volume: 4

Issue: 1

Electronic Location Identifier: e10

Affiliations

[1] ¹ Department of Internal Medicine University of Toledo Medical Center Toledo, OH United States

[2] ² Department of Gastroenterology University of Tennessee Health Science Center Memphis, TN United States

[3] ³ Department of Gastroenterology University of Toledo Medical Center Toledo, OH United States

Author notes

Corresponding Author: Zubair Khan zubair.khan@ 123456utoledo.edu

Author information

Zubair Khan http://orcid.org/0000-0001-5732-7678

Umar Darr http://orcid.org/0000-0002-1487-2286

Muhammad Ali Khan http://orcid.org/0000-0001-8235-1733

Mohamad Nawras http://orcid.org/0000-0001-8345-8049

Basmah Khalil http://orcid.org/0000-0003-4782-2688

Yousef Abdel-Aziz http://orcid.org/0000-0002-2731-8743

Yaseen Alastal http://orcid.org/0000-0002-1308-1132

William Barnett http://orcid.org/0000-0002-7030-1939

Thomas Sodeman http://orcid.org/0000-0002-0626-5347

Ali Nawras http://orcid.org/0000-0001-5133-2468

Article

Publisher ID: v4i1e10

DOI: 10.2196/mededu.9635

PMC ID: 5871737

PubMed ID: 29535080

SO-VID: a725c641-f3a7-4dc4-bf04-ffc85e25bdc6

Copyright © ©Zubair Khan, Umar Darr, Muhammad Ali Khan, Mohamad Nawras, Basmah Khalil, Yousef Abdel-Aziz, Yaseen Alastal, William Barnett, Thomas Sodeman, Ali Nawras. Originally published in JMIR Medical Education (http://mededu.jmir.org), 13.03.2018.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Education, is properly cited. The complete bibliographic information, a link to the original publication on http://mededu.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 11 December 2017

Date revision requested : 24 January 2018

Date revision received : 11 February 2018

Date accepted : 11 February 2018

Comments

Comment on this article

scite_

Cited by 3

See all cited by

Most referenced authors 496

See all reference authors

Submit your digital health research with an established publisher
- celebrating 25 years of open access