When it comes to a cancer diagnosis, timing can be everything – the sooner it’s found, the more treatable it is. But when and how often should someone get screened?
A growing number of educational, interactive tools known as “decision aids†– such as videodiscs, audiotapes, workbooks and pamphlets – are intended to supplement patient-doctor discussions on the pros and cons of timing, methods and frequency for different types of cancer screening.
A University of Michigan study found that despite strong recommendations from the medical community to use these aids to help patients make more well-informed decisions, there is lack of evidence on whether they work – which may lead to fewer doctors using them.
“We continue to see more cancer screening options and also conflicting recommendations on whether to get screened, which method to use and how often it should be done,†says lead author Masahito Jimbo, M.D., Ph.D., M.P.H., associate professor in family medicine and urology at the U-M Medical School.
“Our goal was to determine whether decision aids could potentially lead to better shared decision-making regarding screening between the patient and the clinician. There is evidence that decision aids are fairly effective in improving patient knowledge but we found that they may not be used as well and effectively as they could be.â€
The study appears in CA: A Cancer Journal for Clinicians, a medical journal published for the American Cancer Society.
Decision aids are delivered as self-administered or practitioner administered tools designed to help patients understand the disease, associated tests and treatments and the risks versus benefits of different types of screening. They are designed to help address such issues as whether to get a stool blood test versus a colonoscopy for colon cancer screening or whether women under the age of 50 should get screened for breast cancer at all.
Researchers reviewed 73 decision aids for breast, cervical, colon and prostate cancers. Just half of the decision aids, 36, were evaluated for subsequent screening behavior. Only a quarter of the decision aids, 18, had been assessed for their effect on shared decision making. Little information was available on the feasibility and outcomes of integrating decision aids into actual practice.
