Classification tree analysis to enhance targeting for follow-up exam of colorectal cancer screening
1 Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotuke-city, Tochigi 329-0498, Japan
2 Cancer Scan, 1-18-1-6B, Dogenzaka, Shibuya-ku, Tokyo 150-0043, Japan
3 Epidemiology Research Division Epidemiology Data Center, Japan Clinical Research Support Unit, Yushima D&A Bldg. 3 F 1-10-5 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
4 DataScience Research Institute, 3-10-41-2 F, Minami-Aoyama, Minato-ku, Tokyo 107-0062, Japan
5 Committee for Colorectal Cancer Screening of Omiya Medical Association, 2-107, Onari-cho, Kitaku, Saitama City, Saitama 331-8689, Japan
6 Screening Assessment & Management Division, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
BMC Cancer 2013, 13:470 doi:10.1186/1471-2407-13-470Published: 10 October 2013
Follow-up rate after a fecal occult blood test (FOBT) is low worldwide. In order to increase the follow-up rate, segmentation of the target population has been proposed as a promising strategy, because an intervention can then be tailored toward specific subgroups of the population rather than using one type of intervention for all groups. The aim of this study is to identify subgroups that share the same patterns of characteristics related to follow-up exams after FOBT.
The study sample consisted of 143 patients aged 50–69 years who were requested to undergo follow-up exams after FOBT. A classification tree analysis was performed, using the follow-up rate as a dependent variable and sociodemographic variables, psychological variables, past FOBT and follow-up exam, family history of colorectal cancer (CRC), and history of bowel disease as predictive variables.
The follow-up rate in 143 participants was 74.1% (n = 106). A classification tree analysis identified four subgroups as follows; (1) subgroup with a high degree of fear of CRC, unemployed and with a history of bowel disease (n = 24, 100.0% follow-up rate), (2) subgroup with a high degree of fear of CRC, unemployed and with no history of bowel disease (n = 17, 82.4% follow-up rate), (3) subgroup with a high degree of fear of CRC and employed (n = 24, 66.7% follow-up rate), and (4) subgroup with a low degree of fear of CRC (n = 78, 66.7% follow-up rate).
The identification of four subgroups with a diverse range of follow-up rates for CRC screening indicates the direction to take in future development of an effective tailored intervention strategy.