Acceptability of Localized Cancer Risk Reduction Interventions Among Individuals at Average or High Risk for Cancer

Abstract

Individuals at high risk for cancer, including those already diagnosed with premalignant lesions, can potentially benefit from chemopreventive interventions to reduce cancer risk. However, uptake and acceptability have been hindered due to the risk of systemic toxicity and other adverse effects. Locally delivered chemopreventive agents, where direct action on the primary organ may limit systemic toxicity, are emerging as an option for high-risk individuals. While a number of clinical trials support the development of chemopreventive agents, it is crucial to understand the factors and barriers that influence their acceptability and use. We conducted 36 focus groups with 198 individuals at average and high risk of breast/ovarian, gynecologic, and head/neck/oral and lung cancers to examine the perceptions and acceptability of chemopreventive agents. Participants' willingness to use chemopreven-tive agents was influenced by several factors, including perceived risk of cancer, skepticism around prevention, previous knowledge of chemopreventive agents, support from trusted sources of health information, participation in other cancer-related risk-reduction activities, previous experience with similar modalities, cost, regimen, side effects, and perceived effectiveness of the preventive intervention. Our findings indicate that individuals may be more receptive to locally delivered chemopreventive agents if they perceive themselves to be at high risk for cancer and are given the necessary information regarding regimen and side effects to make an informed decision. Clinical trials that collect additional patient-centered data including side effects and how these interventions fit into an individual's lifestyle are imperative to improve uptake of chemopreventive agents.

Leukoplakia and Immunology: New Chemoprevention Landscapes?

“…In a review, Lo Muzio et al showed that the incidence rate of stomatitis based on the agent used was 54.76% for ridaforolimus, 27.02% for temsirolimus, and 25.07% for everolimus even if the onset of severe stomatitis (G3-G4) was uncommon [114]. Concerning a way to improve the adherence (acceptability) of patients to the chemopreventive protocol treatment, a recent study by Samimi et al indicated that patients could be more receptive to locally delivered chemopreventive compounds if they believe these substances useful for the treatment of cancer [115].…”

Intranasal Iloprost Prevents Tumors in a Murine Lung Carcinogenesis Model

“…Prior preclinical studies predicted efficacy in preventing human lung cancer, as prostacyclin overexpression and iloprost treatment led to reduced tumor number in multiple murine adenocarcinoma models, including cigarette smoke (4)(5)(6). These results are promising, however, locally delivered lung cancer chemoprevention agents may be more appealing to high-risk patients, based on perceived effectiveness and tolerability of an inhaled delivery regimen (7). A recently completed phase I trial is investigating inhaled delivery of iloprost for lung cancer prevention in former smokers (NCT02237183).…”

Assessment of and Interventions for Women at High Risk for Breast or Ovarian Cancer: A Survey of Primary Care Physicians

“…Primary Care Physicians (PCPs) play an increasing role in cancer risk assessment and prescribing of preventive interventions (25). Patients rely on their PCPs to identify their cancer risk and provide recommendations for risk reduction (26)(27)(28). The willingness of a PCP to recommend a cancer preventive intervention is associated with their familiarity with the intervention (29,30).…”