Decision aids sway more patients to undergo colon cancer screening

Providing information tools to help people decide whether to undergo colorectal cancer screening leads to them being more likely to request the procedure.

Colorectal cancer remains a leading cause of cancer-related death, though the number of deaths has dropped over the past 20 years, according to the American Cancer Society. This drop is partly attributed to more people receiving screening tests that catch cancerous growths sooner.

The research team notes that while decision-aid tools like descriptive videos and pamphlets can help convince even more people to be tested, the tools are not widely used yet. Lead study author Paul C. Schroy, MD, of Boston University School of Medicine, explained, “Although decision support tools such as ours have gained popularity, actual implementation into clinical practice has lagged because of perceived barriers related to the disruption of workflow in the clinic, time, and potential costs.”

This study included 825 primary care patients age 50 to 75 years with no symptoms and an average risk of colon cancer. The patients were randomly divided into three groups: one of two intervention groups and one control group. During a routine visit with their primary care physicians, the patients in the two intervention groups viewed a decision-aid video on the benefits and methods of colorectal cancer screening or the video plus a personalized risk assessment tool with feedback. The patients in the control group were shown a generic healthy lifestyle video.

The patients were then queried 6 and 12 months after their office visit. The percentage of patients who completed a colorectal cancer screening test was about 8% higher for those in the decision aid groups compared with the control group (43.1% vs 34.8%). The researchers considered this a moderate impact on colon cancer screening.

Schroy said the challenge still remains to convince providers to implement decision aids into their practices outside of the context of a clinical trial. “Until such time that the barriers can be addressed, we assume that physicians are more likely to utilize the more traditional, albeit less effective, verbal discussion,” he said.

This study was published in American Journal of Preventive Medicine (2012; doi:10.1016/j.amepre.2012.08.018), and the story material is copyright the Health Behavior News Service, part of the Center for Advancing Health.
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