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Updated: Jun 11, 2026
06:28
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Promoting shared decision-making in colorectal cancer screening in primary care: A cluster randomized controlled
Tamara Scharf1,2, Yonas Martin1,3, Marc-Andrea Janggen1
1Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Plos One
|June 9, 2026
Summary
A mailed training program increased colorectal cancer screening using faecal occult blood tests (FOBT) among primary care physicians. However, potential selection bias may affect these findings on FOBT prescriptions.
Area of Science:
- Oncology
- Public Health
- Primary Care Medicine
Background:
- In Switzerland, primary care physicians (PCP) predominantly prescribe colonoscopy for colorectal cancer (CRC) screening.
- This contrasts with guidelines recommending a choice between colonoscopy and faecal occult blood test (FOBT).
Purpose of the Study:
- To evaluate a training program designed to promote shared decision-making for CRC screening among PCPs.
- To assess the impact of the intervention on PCP screening practices.
Main Methods:
- Primary care physicians were randomized to an intervention group (receiving training materials, decision aids, and feedback) or a control group.
- Screening decisions for 40 consecutive patients (ages 50-75) were documented by PCPs four months post-intervention.
Main Results:
- The intervention group showed a higher likelihood of patients being tested or planning FOBT compared to the control group (84% vs. 56%).
- A sensitivity analysis suggested a potential baseline difference in FOBT prescribing rates between groups.
- No significant increase in the proportion of PCPs meeting the primary outcome was observed between intervention and control groups when comparing changes over time.
Conclusions:
- A mailed intervention was associated with increased FOBT prescriptions for colorectal cancer screening.
- Potential selection bias may have influenced the observed results, warranting cautious interpretation.
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