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Fam Cancer. 2017 Oct;16(4):509-516. doi: 10.1007/s10689-017-9986-9.

General practitioner attitudes towards prescribing aspirin to carriers of Lynch Syndrome: findings from a national survey.

Author information

1
Leeds Institute of Health Sciences, University of Leeds, Floor 10, Worsley Building, Leeds, LS2 9JT, UK. s.smith1@leeds.ac.uk.
2
Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK. s.smith1@leeds.ac.uk.
3
Leeds Institute of Health Sciences, University of Leeds, Floor 10, Worsley Building, Leeds, LS2 9JT, UK.
4
Institute of Epidemiology and Healthcare, University College London, London, UK.
5
Harvard T. H. Chan School of Public Health, Center for Population and Development Studies, Harvard University, Cambridge, MA, USA.
6
Institute of Genetic Medicine, Newcastle University, Newcastle, UK.
7
Department of Cancer Studies, University of Leicester, Leicester, UK.
8
Institute for Women's Health, University College London, London, UK.
9
Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.

Abstract

A dose non-inferiority study comparing 100 mg, 300 mg and 600 mg of aspirin for cancer prevention among Lynch Syndrome carriers is underway (Colorectal Adenoma/Carcinoma Prevention Programme trial 3, CaPP3). To guide implementation of the findings, we investigated general practitioner (GP) attitudes towards aspirin prescribing for Lynch Syndrome carriers. We surveyed 1007 UK GPs (9.6% response rate). Using a within-subjects design, GPs read a statement on harms and benefits of aspirin and indicated their willingness to prescribe aspirin at three doses (100 mg, 300 mg, 600 mg). Approximately two-thirds (70.8%) of GPs had heard of Lynch Syndrome or its associated names, and among those 46.7% were aware of the cancer preventive effects of aspirin among carriers. Two-thirds (68.1%) of GPs reported feeling comfortable discussing harms and benefits of aspirin with a Lynch Syndrome patient. Willingness to prescribe was 91.3% at 100 mg, and declined to 81.8% at 300 mg and 62.3% at 600 mg (p < 0.001). In multivariable analyses, willingness to prescribe (600 mg) was higher among GPs ≥50 years (OR 1.46, 95% CI 1.03-2.07), more experienced GPs (OR 1.50, 95% CI 1.10-2.04), GPs who were aware of the cancer preventive effects of aspirin (OR 1.58, 95% CI 1.20-2.09), and those who reported seeing a Lynch Syndrome patient in practice (OR 1.44, 95% CI 1.01-2.05, p = 0.045). GPs report limited awareness of Lynch Syndrome and the preventive effects of aspirin among carriers. To ensure the optimal dose identified in the CaPP3 trial is readily available to patients, prescribing guidance and strategies to educate GPs should be developed.

KEYWORDS:

Aspirin; Chemoprevention; Implementation; Lynch Syndrome; Prescribing; Preventive therapy

PMID:
28434157
PMCID:
PMC5603645
DOI:
10.1007/s10689-017-9986-9
[Indexed for MEDLINE]
Free PMC Article

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