Researchers and policy makers have touted the potential benefits of giving patients information about their personal risk level in helping them decide about cancer screening. Proponents have argued that this is essential to help patients make a truly informed choice about screening, fitting the bioethical goal of autonomy and shared decision-making. Others have argued that guiding screening with personal risk level can increase the positive impact of screening, and reduce the potential harms. But few randomized studies have studied the actual impact of giving this personalized risk information on cancer screening, in any area.
A study led by IUCB Director, Peter Schwartz, MD, PhD, and Project Manager, Karen Schmidt, MSN, RN, CCRP, randomized over 1000 patients to receive personalized risk information about their risk for colorectal cancer. Providers were randomized to receive personalized information, or not, as part of a reminder their patient was due for screening. A paper in Annals of Internal Medicine last year presented the impact of personalized risk information on screening uptake.
Now, a paper just published in the journal Medical Decision Making presents the impact of the personalized risk information on patients’ decision making. Patients who received the personalized information had higher odds of intending to be screened with a colonoscopy or stool test (two approved approaches) but lower odds of intending to have a colonoscopy specifically. At one health system, patients whose provider was sent the personalized information had a higher chance of making a “high quality decision,” in terms of being adequately informed about colorectal cancer and getting the test they preferred.
You can read the full paper here.