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Understanding the Preferences and Considerations of the Public Towards Risk-Stratified Screening for Colorectal Cancer: Insights From Think-Aloud Interviews Based on a Discrete Choice Experiment.
Dennison, Rebecca A; Clune, Reanna J; Morris, Stephen; Thomas, Chloe; Usher-Smith, Juliet A.
Afiliación
  • Dennison RA; Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • Clune RJ; Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • Morris S; Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • Thomas C; Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
  • Usher-Smith JA; Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Health Expect ; 27(4): e14153, 2024 08.
Article en En | MEDLINE | ID: mdl-39030943
ABSTRACT
CONTEXT Risk stratification has been suggested as a strategy for improving cancer screening. Any changes to existing programmes must be acceptable to the public.

OBJECTIVE:

This study aimed to explore the preferences and considerations of individuals relating to the introduction of different risk-based strategies to determine eligibility for colorectal cancer (CRC) screening. STUDY

DESIGN:

Participants completed a discrete choice experiment (DCE) within online interviews. Nine conjoint-analysis tasks were created, each with two potential CRC screening programmes. The attributes included personal risk of CRC, screening invitation strategy and impact. Participants chose between programmes while thinking aloud and sharing their thoughts. Transcripts were analysed using codebook thematic analysis.

PARTICIPANTS:

Twenty participants based in England aged 40-79 years without previous cancer history or medical expertise.

RESULTS:

When choosing between programmes, participants first and primarily looked to prioritise saving lives. The harms associated with screening were viewed as a surprise but also felt by most to be inevitable; the benefits frequently outweighed, therefore, harms were considered less important. Risk stratification using individual characteristics was considered a nuanced approach to healthcare, which tended to be preferred over the age-alone model. Detailed personal risk information could be taken more seriously than non-personalised information to motivate behaviour change. Although it had minimal impact on decision-making, not diverting resources for screening from elsewhere was valued. Individuals who chose not to provide health information were considered irresponsible, while it was important that those with no information to provide should not lose out.

CONCLUSION:

Risk-stratified CRC screening is generally aligned with public preferences, with decisions between possible stratification strategies dominated by saving lives. Even if attributes including risk factors, risk stratification strategy and risk communication contributed less to the overall decision to select certain programmes, some levels more clearly fulfilled public values; therefore, all these factors should be taken into consideration when redesigning and communicating CRC screening programmes. PATIENT OR PUBLIC CONTRIBUTION The primary data source for this study is interviews with 20 members of the public (current, past or future CRC screening invitees). Two public representatives contributed to planning this study, particularly the DCE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Conducta de Elección / Detección Precoz del Cáncer Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Health Expect Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE / SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Conducta de Elección / Detección Precoz del Cáncer Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Health Expect Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE / SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido