Repository logo
 

The impact of information about different absolute benefits and harms on intention to participate in colorectal cancer screening: A think-aloud study and online randomised experiment

Published version
Peer-reviewed

Change log

Authors

Usher-Smith, Juliet A.  ORCID logo  https://orcid.org/0000-0002-8501-2531
Mills, Katie M. 
Riedinger, Christiane 
Saunders, Catherine L. 
Helsingen, Lise M. 

Abstract

Background: There is considerable heterogeneity in individuals’ risk of disease and thus the absolute benefits and harms of population-wide screening programmes. Using colorectal cancer (CRC) screening as an exemplar, we explored how people make decisions about screening when presented with information about absolute benefits and harms, and how those preferences vary with baseline risk, between screening tests and between individuals. Method: We conducted two linked studies with members of the public: a think-aloud study exploring decision making in-depth and an online randomised experiment quantifying preferences. In both, participants completed a web-based survey including information about three screening tests (colonoscopy, sigmoidoscopy, and faecal immunochemical testing) and then up to nine scenarios comparing screening to no screening for three levels of baseline risk (1%, 3% and 5% over 15 years) and the three screening tests. Participants reported, after each scenario, whether they would opt for screening (yes/no). Results: Of the 20 participants in the think-aloud study 13 did not consider absolute benefits or harms when making decisions concerning CRC screening. In the online experiment (n = 978), 60% expressed intention to attend at 1% risk of CRC, 70% at 3% and 77% at 5%, with no differences between screening tests. At an individual level, 535 (54.7%) would attend at all three risk levels and 178 (18.2%) at none. The 27% whose intention varied by baseline risk were more likely to be younger, without a family history of CRC, and without a prior history of screening. Conclusions: Most people in our population were not influenced by the range of absolute benefits and harms associated with CRC screening presented. For an appreciable minority, however, magnitude of benefit was important.

Description

Funder: Research Trainees Coordinating Centre; funder-id: http://dx.doi.org/10.13039/501100000659

Keywords

Research Article, Medicine and health sciences, Research and analysis methods, Biology and life sciences, Social sciences, People and places

Journal Title

PLOS ONE

Conference Name

Journal ISSN

1932-6203

Volume Title

16

Publisher

Public Library of Science
Sponsorship
NIHR School for Primary Care Research (427)
Cancer Research UK (C55650/A21464)
Relationships
Is supplemented by: