Communication about colorectal cancer screening in Britain: public preferences for an expert recommendation

Abstract

Background:Informed decision-making approaches to cancer screening emphasise the importance of decisions being determined by individuals' own values and preferences. However, advice from a trusted source may also contribute to autonomous decision-making. This study examined preferences regarding a recommendation from the NHS and information provision in the context of colorectal cancer (CRC) screening.Methods:In face-to-face interviews, a population-based sample of adults across Britain (n=1964; age 50–80 years) indicated their preference between: (1) a strong recommendation to participate in CRC screening, (2) a recommendation alongside advice to make an individual decision, and (3) no recommendation but advice to make an individual decision. Other measures included trust in the NHS and preferences for information on benefits and risks.Results:Most respondents (84%) preferred a recommendation (47% strong recommendation, 37% recommendation plus individual decision-making advice), but the majority also wanted full information on risks (77%) and benefits (78%). Men were more in favour of a recommendation than women (86% vs 81%). Trust in the NHS was high overall, but the minority who expressed low trust were less likely to want a recommendation.Conclusion:Most British adults want full information on risks and benefits of screening but they also want a recommendation from an authoritative source. An ‘expert' view may be an important part of autonomous health decision-making.

Gender differences in predictors of colorectal cancer screening uptake: a national cross sectional study based on the health belief model

“…More should be done to address this issue because our study found that a doctor’s recommendation for screening was a strong predictor of positive screening behavior in both men and women (adjusted OR 3.50 and 2.35 respectively). This mirrored findings from a recent British study, suggesting that 84% of respondents not only wanted information on the risks and benefits of screening, but also sought recommendation from an “authoritative” source [25]. At the time of the survey, there was no national drive to promote CRC screening.…”

The Role of Patient Activation in Preferences for Shared Decision Making: Results From a National Survey of U.S. Adults

“…For example, members of the public express more interest in being involved in disease prevention decisions such as smoking cessation and lifestyle change (Mansell, Poses, Kazis, & Duefield, 2000) but prefer to be more passive in situations with more immediate consequences (e.g., cancer treatment; Chewning et al, 2012;Davis, Hoffman, & Hsu, 1999). Yet these generalizations are not universal, and research investigating variation across decision types is needed (Mansell et al, 2000;Waller et al, 2012).…”

Colorectal cancer prevention: screening and the role of aspirin

“…While the majority of subjects (78%) wanted full information on risks and benefits, 83% said they would also prefer a recommendation from an expert provider [95].…”