TY - JOUR
T1 - Factors influencing colorectal cancer screening decision-making among average-risk US adults
AU - Zhu, Xuan
AU - Weiser, Emily
AU - Griffin, Joan M.
AU - Limburg, Paul J.
AU - Finney Rutten, Lila J.
N1 - Publisher Copyright:
© 2022
PY - 2022/12
Y1 - 2022/12
N2 - Colorectal cancer (CRC) screening rates remain suboptimal in the US. We examined patient-focused concerns and influence of various factors (e.g., test attributes, provider recommendation) on CRC screening decision-making. We conducted a web survey with 1595 US adults aged 40–75 from a nationally representative panel in November 2019 (completion rate: 31.3 %). Analyses focused on individuals aged 45–75 years at average-risk for CRC (n = 1062). All participants rated their level of concern about various CRC screening test/procedure attributes. Participants who have screened previously designated the three most important attributes for choosing a screening method and rated how various factors influenced their decision to use a particular method. The top concern for participants who have not screened previously was having an invasive procedure (54.2 %) while the top concerns for participants who have screened previously were completing a colon prep (41.3 %) and test/procedure accuracy (41 %). Cost/insurance coverage was most frequently ranked among the most important attributes (48.5 %), followed by where the test can be taken (45.7 %) and test accuracy (43.6 %). Provider recommendation was reported as the major motivator across screening methods. Other factors that were frequently reported as very influential included convenience and comfort for the stool-based methods and scientific/clinical evidence and insurance coverage for colonoscopy. Variations by age, sex, and race/ethnicity were noted. Findings demonstrate that along with provider recommendation, patient preferences regarding test/procedure attributes and preparation requirements are influential in screening decision-making, highlighting the need for clinicians to involve patients in shared decision-making and incorporate patient needs and preferences in establishing screening strategies.
AB - Colorectal cancer (CRC) screening rates remain suboptimal in the US. We examined patient-focused concerns and influence of various factors (e.g., test attributes, provider recommendation) on CRC screening decision-making. We conducted a web survey with 1595 US adults aged 40–75 from a nationally representative panel in November 2019 (completion rate: 31.3 %). Analyses focused on individuals aged 45–75 years at average-risk for CRC (n = 1062). All participants rated their level of concern about various CRC screening test/procedure attributes. Participants who have screened previously designated the three most important attributes for choosing a screening method and rated how various factors influenced their decision to use a particular method. The top concern for participants who have not screened previously was having an invasive procedure (54.2 %) while the top concerns for participants who have screened previously were completing a colon prep (41.3 %) and test/procedure accuracy (41 %). Cost/insurance coverage was most frequently ranked among the most important attributes (48.5 %), followed by where the test can be taken (45.7 %) and test accuracy (43.6 %). Provider recommendation was reported as the major motivator across screening methods. Other factors that were frequently reported as very influential included convenience and comfort for the stool-based methods and scientific/clinical evidence and insurance coverage for colonoscopy. Variations by age, sex, and race/ethnicity were noted. Findings demonstrate that along with provider recommendation, patient preferences regarding test/procedure attributes and preparation requirements are influential in screening decision-making, highlighting the need for clinicians to involve patients in shared decision-making and incorporate patient needs and preferences in establishing screening strategies.
KW - Colonoscopy
KW - Colorectal cancer screening
KW - Fecal immunochemical test/guaiac-based fecal occult blood test
KW - Multi-target stool DNA
KW - Patient decision-making
UR - http://www.scopus.com/inward/record.url?scp=85141540138&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85141540138&partnerID=8YFLogxK
U2 - 10.1016/j.pmedr.2022.102047
DO - 10.1016/j.pmedr.2022.102047
M3 - Article
AN - SCOPUS:85141540138
SN - 2211-3355
VL - 30
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 102047
ER -