Shared decision-making in CA screenings falls short

Cancer Screening Discussions Lack Shared Decision-Making
Cancer Screening Discussions Lack Shared Decision-Making

HealthDay News -- The majority of patients report that shared decision-making (SDM) is lacking when it comes to cancer screening decisions, according to research published in the American Journal of Preventive Medicine.

“According to participants, when healthcare providers discussed screening, they did not routinely present balanced information about the benefits and harms of screening or ask participants' preferences,” reported Richard M. Hoffman, MD, of the University of New Mexico in Albuquerque, and colleagues.

To examine patients' cancer-screening experiences, investigators conducted an internet-based survey of 1,134 patients aged 50 years and older, who made breast, colorectal, and prostate cancer-screening decisions within the previous two years. Responses included participants' perceived cancer risk; how informed they felt about cancer tests; whether their health care provider addressed pros/cons of testing, presented the option of no testing, and elicited their input; whether they were tested; and their confidence in the screening decision.

The majority of decisions (1,098 of 1,134) were discussed with a health care provider (354 for breast cancer, 598 for colorectal cancer, 146 for prostate cancer). Pros of screening were addressed more often compared with cons (51% to 67% versus 7% to14%, respectively), according to the study authors.

Most of the time (63% to 71%), providers explained that testing was optional, but only 27% to 38% of participants reported SDM. The majority underwent screening (69% to 93%) and most (55% to 76%) would definitely make the same decision again.

“Supporting SDM by better educating patients about the risks and benefits of screening and normalizing cancer risk perception could potentially improve the quality of cancer screening discussions,” wrote the researchers.

References

  1. Hoffman R et al. American Journal of Preventive Medicine. 2014; doi: http://dx.doi.org/10.1016/j.amepre.2014.04.011
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