Colon cancer patient information seeking and the adoption of targeted therapy for on-label and off-label indications

Authors

  • Stacy W. Gray MD, AM,

    Corresponding author
    1. Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Massachusetts
    • Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, 44 Binney Street, SM 224, Boston, MA 02115===

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    • Fax: (617) 632-3161

  • Katrina Armstrong MD, MSCE,

    1. School of Medicine and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Angela DeMichele MD, MSCE,

    1. School of Medicine and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
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  • J. Sanford Schwartz MD,

    1. School of Medicine and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Robert C. Hornik PhD

    1. Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
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  • The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions.

Abstract

BACKGROUND:

Despite the rise in publicly available cancer information, little is known about the association between patient information seeking and the adoption of cancer technologies. The authors of this report investigated the relation between patient information seeking and awareness about and receipt of novel targeted therapy (TT) for colon cancer among patients for whom therapy is approved by the US Food and Drug Administration (FDA) and among patients for whom therapy is not FDA approved.

METHODS:

A retrospective, population-based survey of 633 colon cancer patients were identified through the Pennsylvania Cancer Registry. Outcome measures were self-reported awareness about and receipt of TT (bevacizumab and cetuximab).

RESULTS:

After adjusting for sociodemographic characteristics, high levels of treatment information seeking were associated strongly with hearing about TT (odds ratio [OR], 2.83; 95% confidence interval [CI], 1.49-5.38) and receiving TT (OR, 3.22; 95% CI, 1.36-7.62). These associations were present for patients with metastatic disease, for whom the use of TT is FDA approved, and for patients with localized disease, for whom the use of TT is not FDA approved (P for interactions = .29). Internet use (OR, 2.88; 95% CI, 1.40-5.94) and newspaper/magazine use (OR, 3.44; 95% CI, 1.34-8.84) were associated with hearing about TT. Seeking information from nontreating physicians was associated with hearing about TT (OR, 1.95; 95% CI, 1.03-3.68) and receiving TT (OR, 2.64; 95% CI, 1.16-5.97).

CONCLUSIONS:

Patient information seeking was related to the adoption of TT for colon cancer in both appropriate and inappropriate clinical settings. These findings emphasize the importance of exploring patient influence on physician prescribing patterns and understanding the impact of information seeking on cancer outcomes. Cancer 2009. © 2009 American Cancer Society.

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