Marc S. Piper|Jennifer K. Maratt|Brian J. Zikmund?Fisher|Carmen L. Lewis|Jane Forman|Sandeep Vijan|Valbona Metko|Sameer D. Saini
Patient Attitudes Toward Individualized Recommendations to Stop Low-Value Colorectal Cancer Screening
Providence Park Hospital|Michigan State University|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Colorado Anschutz Medical Campus|University of Colorado Denver|VA Center for Clinical Management Research|Health Services Research & Development|VA Ann Arbor Healthcare System|University of Michigan–Ann Arbor|VA Center for Clinical Management Research|Health Services Research & Development|VA Ann Arbor Healthcare System|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|VA Center for Clinical Management Research|Health Services Research & Development|VA Ann Arbor Healthcare System
guidelines colorectal cancer crc screening recommend individualized approach older adults informed consideration life expectancy cancer risk however little known patients perceive individualized screening recommendationsto assess veterans attitudes toward comfort cessation lowvalue crc screening defined screening patient benefit expected small based quantitative estimates hypothetical risk calculatorsthis survey study included patients older 50 years undergone prior screening colonoscopy normal results veterans affairs ann arbor healthcare system total 1500 surveys mailed potential participants november 1 2010 january 1 2012 survey data analyzed january 1 2016 december 31 2017response question personally serious health problems likely shorten life doctor think screening would much benefit based calculator comfortable would getting screening colonoscopiesof 1500 surveys mailed 85 returned sender leaving 1415 potential respondents 1054 respondents median age range 6069 years 884 859 white 965 942 male completed survey response rate 745 total 300 287 comfortable cessation lowvalue crc screening 509 493 thought age never used decide stop screening addition 332 317 thought reasonable use life expectancy calculators 255 243 thought reasonable use crc risk calculators guide decisions ordered logistic regression analysis factors associated comfort screening cessation 1 higher trust physician odds ratio 119 95 ci 107132 2 higher perceived health status 141 95 ci 123161 3 higher barriers screening 120 95 ci 111130 factors associated less comfort screening cessation included 1 greater perceived effectiveness screening 086 95 ci 080094 2 greater perceived threat crc 081 95 ci 073089the findings suggest many veterans strong preferences screening cessation even given detailed information benefit may low efforts tailor screening recommendations may met resistance unless accompanied efforts address underlying perceptions benefit screening