Patient preferences for colon cancer screening
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OBJECTIVE: To measure patient preferences for four different screening strategies: annual fecal occult blood testing (FOBT) alone; flexible sigmoidoscopy (FSIG) every 5 years alone; both annual FOBT and FSIG every 5 years; or no screening.
SETTING: University internal medicine clinic.
PATIENTS: Convenience sample of 146 adults (aged 50–75 years) with no previous history of colon cancer.
INTERVENTION: Three-part educational program on colon cancer screening administered verbally by trained research assistants.
MEASUREMENTS AND MAIN RESULTS: Patient preferences for screening were measured at three points: after descriptive information about colon cancer and screening options (testing procedure information); after information about test performance but with no out-of-pocket costs (test performance information); and finally with hypothetical out-of-pocket costs (cost information). After only descriptive test information, the most popular strategies were FOBT alone (45%) or both tests (38%). Fewer patients preferred FSIG alone (13%). After information about test performance, more subjects preferred both tests (47%), and fewer subjects preferred FOBT alone (36%) (p=.12). With hypothetical out-of-pocket costs, the proportion preferring FOBT alone increased to 53%, while those preferring both tests decreased to 31% (p<.001). Less than 5% of patients preferred no screening.
CONCLUSIONS: Patient preferences for colon cancer screening were modestly sensitive to information about test performance and strongly sensitive to out-of-pocket costs. The heterogeneity of patients’ preferences for how to be screened supports informed shared decision making as a possible means of improving colon cancer screening.
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- Patient preferences for colon cancer screening
Journal of General Internal Medicine
Volume 14, Issue 7 , pp 432-437
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- colon cancer
- patient preferences
- shared decision making
- Industry Sectors
- Author Affiliations
- 1. the Division of General Internal Medicine and RWJ Clinical Scholars Program, University of North Carolina School of Medicine, Chapel Hill, NC
- 2. Department of Health Behavior and Health Education, University of North Carolina School of Public Health, Chapel Hill, NC