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Got It, Hide thisVolk RJ, Linder SK, Lopez-Olivo MA, et al. Patient Decision Aids for Colorectal Cancer Screening: A Systematic Review and Meta-analysis. Am J Prev Med. 2016;5:779-91.
Do patient decision aids help people understand screening for colorectal cancer? Are people who use decision aids more likely to be screened for colorectal cancer?
Colorectal cancer is a major cause of cancer death, but screening and treatment have reduced the risk of having colorectal cancer and dying from it. Many tests are used to screen for colorectal cancer, but people often don’t have the tests at all or as frequently as they should.
Patient decision aids provide information about the procedures used to screen for colorectal cancer, along with their benefits and risks. They may help people to decide whether to screen and which test to have.
The researchers did a systematic review, searching for studies of decision aids published up to July 2015.
They found 21 studies, including 14 randomized controlled trials.
The studies included 11,900 people who were at average risk of having colorectal cancer. Most were 50 to 74 years old.
13 decision aids were compared with control conditions (see below).
Decision aids
Control conditions included
Patient decision aids increased the accuracy of people’s knowledge about colorectal screening compared with both no screening information and the usual colorectal cancer screening information.
Compared with no screening information, decision aids
Compared with the usual colorectal cancer screening information, decision aids
Decision aids help people understand enough about colorectal cancer screening to make informed decisions compared with the information that is usually provided. People who use decision aids are more likely to be screened for colorectal cancer than people who have no information, but not more likely than people who have the usual screening information.
Comparator | Outcomes | Number of studies (and people) | Rate of events with decision aids vs comparator | Absolute effect of decision aids |
Usual screening information | Adequate knowledge | 4 studies (2780 people) | 57% vs 19% | About 38 more people out of 100 had enough knowledge to make an informed decision. |
| Intent to screen | 6 studies (3075 people) | 52% vs 52% | No effect |
| Completing screening by 24 weeks | 5 studies (2640 people) | 33% vs 28% | No effect* |
No information | Intent to screen | 2 studies (495 people) | 40% vs 26% | About 14 more people out of 100 planned to be screened. |
| Completing screening at 16 to 52 weeks | 7 studies (4457 people) | 47% vs 40% | About 7 more people out of 100 were screened. |