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Randomized Controlled Trial
. 2011 Jun 2:342:d3193.
doi: 10.1136/bmj.d3193.

Effect of evidence based risk information on "informed choice" in colorectal cancer screening: randomised controlled trial

Anke Steckelberg  1 , Christian Hülfenhaus, Burkhard Haastert, Ingrid Mühlhauser
Affiliations
Randomized Controlled Trial

Effect of evidence based risk information on "informed choice" in colorectal cancer screening: randomised controlled trial

Anke Steckelberg et al. BMJ. .

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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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

None
Flow of participants through trial. *At start of study 9/1586 randomised participants withdrew informed consent and were therefore excluded
See this image and copyright information in PMC

References

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