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Patient preferences for colon cancer screening
M Pignone1, D Bucholtz, R Harris
1Division of General Internal Medicine, University of North Carolina School of Medicine, Chapel Hill 27599-7110, USA.
Journal of General Internal Medicine
|July 27, 1999
Summary
Patient preferences for colon cancer screening strategies like fecal occult blood testing (FOBT) and flexible sigmoidoscopy (FSIG) are influenced by test performance and cost. Shared decision-making can improve screening uptake.
Area of Science:
- Oncology
- Preventive Medicine
- Health Services Research
Background:
- Colorectal cancer screening is crucial for early detection and prevention.
- Multiple screening modalities exist, including fecal occult blood testing (FOBT) and flexible sigmoidoscopy (FSIG).
- Understanding patient preferences is key to optimizing screening strategies.
Purpose of the Study:
- To evaluate patient preferences for different colorectal cancer screening strategies.
- To assess how information on test performance and cost influences these preferences.
- To explore the role of shared decision-making in colorectal cancer screening.
Main Methods:
- A survey was conducted at a university internal medicine clinic.
- 146 adults aged 50-75 without prior colon cancer history participated.
- Participants received a three-part educational program on screening options.
Main Results:
- Initially, FOBT alone or combined FOBT/FSIG were preferred.
- Test performance information slightly shifted preference towards combined testing.
- Out-of-pocket costs significantly increased preference for FOBT alone and decreased preference for combined testing.
- Less than 5% preferred no screening.
Conclusions:
- Patient preferences for colorectal cancer screening are moderately sensitive to test performance and highly sensitive to cost.
- The diversity in patient preferences supports the use of informed shared decision-making.
- Shared decision-making may enhance the effectiveness of colorectal cancer screening programs.