Shared Decision Making in Colorectal Cancer Screening: A Scoping Review

Colorectal cancer (CRC) is easily detectable with screening, but due to a variety of factors, over a third of eligible people do not get screened. One barrier to people getting adequate screening is confusion about what type of test to use. Shared decision making (SDM) is a way for the clinician to help the patient decide about whether to get screened for CRC and if so, which test to use. This scoping review examines literature about shared decision making in CRC screening to identify key factors affecting a patient's decision.

We identified studies published from January 1, 2010 through May 18, 2024 through searching 4 databases. Studies were peer reviewed publications in English that investigated the role of shared decision making in colorectal cancer screening in average risk adults, aged 45 -75, in the United States and Canada. Two independent researchers screened all titles and abstracts for eligibility and reviewed all included full text articles. The included studies were examined for themes affecting a patient's choice of screening test.

Of the 5672 unique records identified, we included 28 studies in this scoping review. Four themes emerged as being important to the process of shared decision making in colon cancer screening: knowledge of specific aspects of each test, clinician recommendation, acknowledgment of strong emotions surrounding screening, and importance of external factors in decisions around screening. Patients relied on family members for information about screening and made decisions about screening using this information as well as logistics of the test chosen.

Future work can focus on the importance of external factors in screening decisions and recognizing and addressing the real emotions about CRC screening.