Patients' preferences and priorities regarding colorectal cancer screening

James G. Dolan, Emily Boohaker, Jeroan Allison, Thomas Imperiale

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background. US colorectal cancer screening guidelines for people at average risk for colorectal cancer endorse multiple screening options and recommend that screening decisions reflect individual patient preferences. Methods. The authors used the analytic hierarchy process (AHP) to ascertain decision priorities of people at average risk for colorectal cancer attending primary care practices in Rochester, New York; Birmingham, Alabama; and Indianapolis, Indiana. The analysis included 4 decision criteria, 3 subcriteria, and 10 options. Results. Four hundred eighty-four people completed the study; 66% were female, 49% were African American, 9% had low literacy skills, and 27% had low numeracy skills. Overall, preventing cancer was given the highest priority (mean priority 55%), followed by avoiding screening test side effects (mean priority 17%), minimizing false-positive test results (mean priority 15%), and the combined priority of screening frequency, test preparation, and the test procedure(s) (mean priority 14%). Hierarchical cluster analysis revealed 6 distinct priority groupings containing multiple instances of decision priorities that differed from the average value by a factor of 4 or more. More than 90% of the study participants fully understood the concepts involved, 79% met AHP analysis quality standards, and 88% were willing to use similar methods to help make important health care decisions. Conclusion. These results highlight the need to facilitate incorporation of patient preferences into colorectal cancer screening decisions. The large number of study participants able and willing to perform the complex AHP analysis used for this study suggests that the AHP is a useful tool for identifying the patient-specific priorities needed to ensure that screening decisions appropriately reflect individual patient preferences.

Original languageEnglish
Pages (from-to)59-70
Number of pages12
JournalMedical Decision Making
Volume33
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Patient Preference
Early Detection of Cancer
Colorectal Neoplasms
African Americans
Cluster Analysis
Primary Health Care
Guidelines
Delivery of Health Care
Neoplasms

Keywords

  • analytic hierarchy process
  • colorectal cancer
  • prevention
  • screening
  • shared decision making

ASJC Scopus subject areas

  • Health Policy
  • Medicine(all)

Cite this

Patients' preferences and priorities regarding colorectal cancer screening. / Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas.

In: Medical Decision Making, Vol. 33, No. 1, 01.2013, p. 59-70.

Research output: Contribution to journalArticle

Dolan, James G. ; Boohaker, Emily ; Allison, Jeroan ; Imperiale, Thomas. / Patients' preferences and priorities regarding colorectal cancer screening. In: Medical Decision Making. 2013 ; Vol. 33, No. 1. pp. 59-70.
@article{7db5a243429e4d8e8dd4e763ad25c63b,
title = "Patients' preferences and priorities regarding colorectal cancer screening",
abstract = "Background. US colorectal cancer screening guidelines for people at average risk for colorectal cancer endorse multiple screening options and recommend that screening decisions reflect individual patient preferences. Methods. The authors used the analytic hierarchy process (AHP) to ascertain decision priorities of people at average risk for colorectal cancer attending primary care practices in Rochester, New York; Birmingham, Alabama; and Indianapolis, Indiana. The analysis included 4 decision criteria, 3 subcriteria, and 10 options. Results. Four hundred eighty-four people completed the study; 66{\%} were female, 49{\%} were African American, 9{\%} had low literacy skills, and 27{\%} had low numeracy skills. Overall, preventing cancer was given the highest priority (mean priority 55{\%}), followed by avoiding screening test side effects (mean priority 17{\%}), minimizing false-positive test results (mean priority 15{\%}), and the combined priority of screening frequency, test preparation, and the test procedure(s) (mean priority 14{\%}). Hierarchical cluster analysis revealed 6 distinct priority groupings containing multiple instances of decision priorities that differed from the average value by a factor of 4 or more. More than 90{\%} of the study participants fully understood the concepts involved, 79{\%} met AHP analysis quality standards, and 88{\%} were willing to use similar methods to help make important health care decisions. Conclusion. These results highlight the need to facilitate incorporation of patient preferences into colorectal cancer screening decisions. The large number of study participants able and willing to perform the complex AHP analysis used for this study suggests that the AHP is a useful tool for identifying the patient-specific priorities needed to ensure that screening decisions appropriately reflect individual patient preferences.",
keywords = "analytic hierarchy process, colorectal cancer, prevention, screening, shared decision making",
author = "Dolan, {James G.} and Emily Boohaker and Jeroan Allison and Thomas Imperiale",
year = "2013",
month = "1",
doi = "10.1177/0272989X12453502",
language = "English",
volume = "33",
pages = "59--70",
journal = "Medical Decision Making",
issn = "0272-989X",
publisher = "SAGE Publications Inc.",
number = "1",

}

TY - JOUR

T1 - Patients' preferences and priorities regarding colorectal cancer screening

AU - Dolan, James G.

AU - Boohaker, Emily

AU - Allison, Jeroan

AU - Imperiale, Thomas

PY - 2013/1

Y1 - 2013/1

N2 - Background. US colorectal cancer screening guidelines for people at average risk for colorectal cancer endorse multiple screening options and recommend that screening decisions reflect individual patient preferences. Methods. The authors used the analytic hierarchy process (AHP) to ascertain decision priorities of people at average risk for colorectal cancer attending primary care practices in Rochester, New York; Birmingham, Alabama; and Indianapolis, Indiana. The analysis included 4 decision criteria, 3 subcriteria, and 10 options. Results. Four hundred eighty-four people completed the study; 66% were female, 49% were African American, 9% had low literacy skills, and 27% had low numeracy skills. Overall, preventing cancer was given the highest priority (mean priority 55%), followed by avoiding screening test side effects (mean priority 17%), minimizing false-positive test results (mean priority 15%), and the combined priority of screening frequency, test preparation, and the test procedure(s) (mean priority 14%). Hierarchical cluster analysis revealed 6 distinct priority groupings containing multiple instances of decision priorities that differed from the average value by a factor of 4 or more. More than 90% of the study participants fully understood the concepts involved, 79% met AHP analysis quality standards, and 88% were willing to use similar methods to help make important health care decisions. Conclusion. These results highlight the need to facilitate incorporation of patient preferences into colorectal cancer screening decisions. The large number of study participants able and willing to perform the complex AHP analysis used for this study suggests that the AHP is a useful tool for identifying the patient-specific priorities needed to ensure that screening decisions appropriately reflect individual patient preferences.

AB - Background. US colorectal cancer screening guidelines for people at average risk for colorectal cancer endorse multiple screening options and recommend that screening decisions reflect individual patient preferences. Methods. The authors used the analytic hierarchy process (AHP) to ascertain decision priorities of people at average risk for colorectal cancer attending primary care practices in Rochester, New York; Birmingham, Alabama; and Indianapolis, Indiana. The analysis included 4 decision criteria, 3 subcriteria, and 10 options. Results. Four hundred eighty-four people completed the study; 66% were female, 49% were African American, 9% had low literacy skills, and 27% had low numeracy skills. Overall, preventing cancer was given the highest priority (mean priority 55%), followed by avoiding screening test side effects (mean priority 17%), minimizing false-positive test results (mean priority 15%), and the combined priority of screening frequency, test preparation, and the test procedure(s) (mean priority 14%). Hierarchical cluster analysis revealed 6 distinct priority groupings containing multiple instances of decision priorities that differed from the average value by a factor of 4 or more. More than 90% of the study participants fully understood the concepts involved, 79% met AHP analysis quality standards, and 88% were willing to use similar methods to help make important health care decisions. Conclusion. These results highlight the need to facilitate incorporation of patient preferences into colorectal cancer screening decisions. The large number of study participants able and willing to perform the complex AHP analysis used for this study suggests that the AHP is a useful tool for identifying the patient-specific priorities needed to ensure that screening decisions appropriately reflect individual patient preferences.

KW - analytic hierarchy process

KW - colorectal cancer

KW - prevention

KW - screening

KW - shared decision making

UR - http://www.scopus.com/inward/record.url?scp=84872326416&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872326416&partnerID=8YFLogxK

U2 - 10.1177/0272989X12453502

DO - 10.1177/0272989X12453502

M3 - Article

C2 - 22895558

AN - SCOPUS:84872326416

VL - 33

SP - 59

EP - 70

JO - Medical Decision Making

JF - Medical Decision Making

SN - 0272-989X

IS - 1

ER -