November 27, 2012
Lisa Madlensky, PhD, an Associate Professor at the University of California, San Diego, received a grant from the Foundation in spring 2006 to study ways to reduce the risk of colorectal cancer in patients with polyps and their families. This month we caught up with her to learn more about her research on the complex communication about colon polyps between doctors, patients and their families.
Tell us about your project aimed at reducing colorectal cancer risk in polyp patients and their families.
Although all of the current guidelines for colorectal cancer screening describe the importance of a family history of cancer, they also include a family history of polyps as a risk factor for patients and doctors to be aware of. But we suspected that knowing about your family history of polyps is difficult, because there is a whole chain of communication that this information has to pass through: When patients are diagnosed with colon polyps (in particular, the kind called an “adenoma“), they need to be told about the polyps by their gastroenterologists. Then the patients need to tell their relatives. Then the relatives need to tell their own doctors. We had no idea if this communication was something that happened routinely, or if there were breaks in the communication chain. So we set out to ask patients who had polyps what they were told by their doctors and whether they in turn told their family members.
What did you find out through your research on communication about colorectal polyps?
Our most interesting finding was that very few patients with polyps reported that their doctors told them to share that information with their family members. We also found that most patients with polyps didn’t tell all their siblings about their colonoscopies, though women were more likely than men to tell all their siblings and people with family histories of colon cancer were also more likely to tell their siblings.
Based on your research, what recommendations do you have for patients undergoing a colonoscopy?
Always ask for a copy of your colonoscopy report, including the pathology reports from any biopsies that were taken. Sometimes the doctor performing the colonoscopy will remove polyps during the procedure, but the type of polyp cannot be known until the pathology report is issued. Many people thought they had polyps removed, but then the pathology report found that what looked like a polyp was just normal colon tissue. We recommend that people with adenomas tell their brothers and sisters about those polyps, especially if there is a family history of colon cancer. If several people in the same family have had colon cancer and/or colon adenomas, they can consider asking for a referral to a cancer genetics clinic to see if genetic testing makes sense for their family.
How did receiving a Prevent Cancer Foundation grant impact your research?
It’s challenging to find funding for research in the area of patient-physician communication, or to do research that involves surveys. My colleagues and I are so grateful for the funding from the Prevent Cancer Foundation, because it enabled us to get a really good understanding of these communication issues. Since colorectal cancer is one of the few cancers that can be detected at an early stage, or prevented altogether, it is critically important for people to communicate openly with their doctors and family members so that they can get the right test at the right age. We are now working to develop some new and innovative tools to help with this complicated chain of communication and would not have been able to move forward without the funding from the Prevent Cancer Foundation.