Steckelberg A, Hülfenhaus C, Haastert B, Mühlhauser I. Effect of evidence based risk information on "informed choice" in colorectal cancer screening: randomised controlled trial.
BMJ 2011;
342:d3193. [PMID:
21636633 PMCID:
PMC3106362 DOI:
10.1136/bmj.d3193]
[Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE
To compare the effect of evidence based information on risk with that of standard information on informed choice in screening for colorectal cancer.
DESIGN
Randomised controlled trial with 6 months' follow-up.
SETTING
German statutory health insurance scheme.
PARTICIPANTS
1577 insured people who were members of the target group for colorectal cancer screening (age 50-75, no history of colorectal cancer).
INTERVENTIONS
Brochure with evidence based risk information on colorectal cancer screening and two optional interactive internet modules on risk and diagnostic tests; official information leaflet of the German colorectal cancer screening programme (control).
MAIN OUTCOME MEASURE
The primary end point was "informed choice," comprising "knowledge," "attitude," and "combination of actual and planned uptake." Secondary outcomes were "knowledge" and "combination of actual and planned uptake." Knowledge and attitude were assessed after 6 weeks and combination of actual and planned uptake of screening after 6 months.
RESULTS
The response rate for return of both questionnaires was 92.4% (n = 1457). 345/785 (44.0%) participants in the intervention group made an informed choice, compared with 101/792 (12.8%) in the control group (difference 31.2%, 99% confidence interval 25.7% to 36.7%; P < 0.001). More intervention group participants had "good knowledge" (59.6% (n = 468) v 16.2% (128); difference 43.5%, 37.8% to 49.1%; P < 0.001). A "positive attitude" towards colorectal screening prevailed in both groups but was significantly lower in the intervention group (93.4% (733) v 96.5% (764); difference -3.1%, -5.9% to -0.3%; P<0.01). The intervention had no effect on the combination of actual and planned uptake (72.4% (568) v 72.9% (577); P = 0.87).
CONCLUSIONS
Evidence based risk information on colorectal cancer screening increased informed choices and improved knowledge, with little change in attitudes. The intervention did not affect the combination of actual and planned uptake of screening. Trial registration Current Controlled Trials ISRCTN47105521.
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