Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
Patient Educ Couns. 2013 Jun;91(3):318-25. doi: 10.1016/j.pec.2013.01.004. Epub 2013 Feb 8.
To evaluate the level of informed decision making in a randomized controlled trial comparing colonoscopy and CT-colonography for colorectal cancer screening.
8844 citizens aged 50-75 were randomly invited to colonoscopy (n=5924) or CT-colonography (n=2920) screening. All invitees received an information leaflet. Screenees received a questionnaire within 4 weeks before the planned examination, non-screenees 4 weeks after the invitation. A decision was categorized as informed when characterized by sufficient decision-relevant knowledge and consistent with personal attitudes toward participation in screening.
Knowledge and attitude items were completed by 1032/1276 colonoscopy screenees (81%), by 698/4648 colonoscopy non-screenees (15%), by 824/982 CT-colonography screenees (84%) and by 192/1938 CT-colonography non-screenees (10%). 1027 colonoscopy screenees (>99%) and 815 CT-colonography screenees (99%) had adequate knowledge; 915 (89%) and 742 (90%) had a positive attitude. 675 non-screenees invited to colonoscopy (97%) and 182 invited to CT-colonography (95%) had adequate knowledge; 344 (49%) and 94 (49%) expressed a negative attitude.
A large majority of screenees made an informed decision on participation. Almost half of responding non-screenees, made an uninformed decision, suggesting additional barriers to participation.
Efforts to understand the additional barriers will create opportunities to facilitate informed participation to colorectal cancer screening.
评估一项比较结肠镜检查与 CT 结肠成像用于结直肠癌筛查的随机对照试验中知情决策的水平。
8844 名 50-75 岁的公民被随机邀请接受结肠镜检查（n=5924）或 CT 结肠成像（n=2920）筛查。所有受邀者均收到一份信息传单。筛检者在计划检查前 4 周内收到一份问卷，非筛检者在邀请后 4 周内收到一份问卷。当决策具有足够的决策相关知识且与个人对筛查参与的态度一致时，则将其归类为知情决策。
结肠镜检查筛检者中有 1032/1276 人（81%）、结肠镜检查非筛检者中有 698/4648 人（15%）、CT 结肠成像筛检者中有 824/982 人（84%）和 CT 结肠成像非筛检者中有 192/1938 人（10%）完成了知识和态度项目。1027 名结肠镜检查筛检者（>99%）和 815 名 CT 结肠成像筛检者（99%）具有足够的知识；915 名（89%）和 742 名（90%）具有积极的态度。675 名未接受结肠镜检查邀请的非筛检者（97%）和 182 名接受 CT 结肠成像邀请的非筛检者（95%）具有足够的知识；344 名（49%）和 94 名（49%）表达了消极态度。
绝大多数筛检者对参与做出了知情决策。近一半做出无信息决策的回应非筛检者，表明参与存在额外障碍。
努力了解额外的障碍将为促进结直肠癌筛查的知情参与创造机会。
