Institute of Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Hannover, Germany.
BMJ Open. 2018 Jul 13;8(7):e019127. doi: 10.1136/bmjopen-2017-019127.
Primary colonoscopic screening is considered to be of great benefit but also has the potential to cause severe harm. Thus, eligible subjects should be supported in making an informed choice whether to participate.
To identify information on screening colonoscopy that colonoscopy-naïve subjects rate as particularly important for decision making.
Survey of German statutory health insurance members using a written questionnaire in November 2015.
Colonoscopy-naïve individuals aged 50 to 65 years.
Importance of key information about screening colonoscopy, including potential risks and benefits, baseline risk of colorectal cancer/polyps and practical aspects of the procedure, as well as associations between participants' characteristics and their judgement of information as to being 'very important'.
Of 1871 respondents (overall response rate: 31%), a subgroup of 370 colonoscopy-naïve subjects was eligible for inclusion (average age: 55 years, 47% male). Information on the risks was rated as very important by most respondents, unimportant by 6%. Information on the benefits was considered unimportant by 26%. Regression analysis showed that less educated persons regarded most items to be more often relevant than highly educated subjects. A greater proportion of women than men rated details regarding pain and practical aspects as very important. Subjects with a low educational level living alone were identified as the group with the least interest in information on risks.
Cultivating awareness around the central meaning of the (quantitative) benefits of screening in informed decision making should be focused on more in future information materials. The high requirement of less educated people to become more informed provides a strong motivation for further efforts to develop evidence-based information that adequately informs this group. Tailoring information according to gender-specific needs may be warranted in light of the observed differences in information preferences between women and men.
初步结肠镜筛查被认为具有巨大益处，但也有可能造成严重伤害。因此，应支持合格的受试者做出知情选择，决定是否参与。
确定结肠镜筛查的信息，这些信息是结肠镜筛查初筛者在决策时认为特别重要的。
2015 年 11 月对德国法定健康保险成员进行书面问卷调查。
年龄在 50 至 65 岁之间的结肠镜筛查初筛者。
有关筛查结肠镜的关键信息的重要性，包括潜在风险和益处、结直肠癌/息肉的基线风险以及该程序的实际方面，以及参与者特征与他们对信息“非常重要”的判断之间的关联。
在 1871 名受访者（总体回应率：31%）中，有 370 名结肠镜筛查初筛者符合纳入标准（平均年龄 55 岁，47%为男性）。大多数受访者认为有关风险的信息非常重要，不重要的占 6%。有 26%的人认为有关益处的信息不重要。回归分析显示，受教育程度较低的人比受教育程度较高的人更倾向于认为大多数项目更相关。与男性相比，更多的女性认为有关疼痛和实际方面的详细信息非常重要。教育程度低、独居的人被认为是对风险信息最不感兴趣的群体。
在知情决策中，应更加关注培养对筛查（定量）益处的核心意义的认识。受教育程度较低的人对获取更多信息的高要求为进一步努力开发能充分告知这一群体的循证信息提供了强大动力。鉴于观察到女性和男性之间在信息偏好方面存在差异，根据性别需求调整信息可能是合理的。
