Abstract
OBJECTIVE: Although chemopreventive strategies such as acetylsalicylic acid have shown potential in cancer prevention, they also entail adverse effects. This leads to growing interest in "natural" compounds, such as plant-based extracts, which may offer preventive benefits with fewer side effects. However, little is known aboutindividuals' personal attitudes towards conventional medications and complementary or alternative therapies when they are eligible for various cancer screening and prevention programmes. The present study aims to investigate the attitude toward medications and various therapies, as well as their prescription, among subjects participating in a clinical trial on the prevention of colorectal adenomas using green tea extract. A further goal was to assess whether the study predominantly attracted individuals with a strong preference for natural products or a more diverse set of opinions. METHODS: 992 participants (age 50-80 years) of the MIRACLE study (a randomised study comparing green tea extract vs. placebo for secondary prevention of colorectal adenomas, NCT01360320) in 40 study centres across Germany received a 25-item, expert-based questionnaire regarding their attitude towards different medications and therapies including complementary and alternative medicine. Basic characteristics including age, gender, ECOG status, and lifestyle factors were also recorded. An exploratory factor analysis was used to group the items into eight thematic areas, which were then analysed for potential associations with the participants' baseline characteristics. RESULTS: Response rate to the questionnaire was 94.3% (935/992). Survey participants mainly expressed positive attitudes towards both conventional and complementary medicine. Most were open to genetic testing for personalised treatment. Comparing the categories of the exploratory factor analysis revealed that female gender and regular exercise were associated with the regular use of alternative healing methods (i.e. acupuncture or homeopathic medicine). A more favourable view of alternative approaches was more common among younger and better-educated individuals, but the same groups also rated conventional medicine less negatively. CONCLUSION: The findings of this study reveal a relatively high level of openness towards both conventional and alternative medicine among participants of the MIRACLE trial, as well as certain features, such as age, gender, and education that impact on the attitude towards medications and therapies among participants in a study on secondary prevention of colorectal polyps by green tea extract. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01360320.