Men and blacks less likely to be aware of cancer screening benefits
Research Activities, December 2010, No. 364
Screening for cancer (i.e., Pap smear, colonoscopy, mammogram) is an important aspect of primary care. Whenever possible, patients should actively engage in the decisionmaking process so that the risks and benefits of these screenings are understood. However, a new study has found differences in patients' perceptions of this informed decisionmaking. Specifically, characteristics such as gender, race, and education level are associated with how well patients understand the benefits of cancer screening.
Researchers surveyed a diverse group of 467 women and 257 men (aged 50 and over) from 7 primary care practices in North Carolina. The 33-item survey asked about their feelings about various cancer screening tests. Nearly 40 percent of patients felt unsure about what to do about cancer screening, although the majority (76.4 percent) knew about the benefits. More than half also were aware of the risks. Nearly 70 percent had made informed decisions about cancer screening. Over 80 percent said that their doctors regularly asked for their input regarding cancer screening tests.
Men had 46 percent greater odds than women of not knowing the benefits of cancer screening. Compared with whites, blacks had 70 percent increased odds of not knowing the benefits of cancer screening and 50 percent increased odds of reporting they had not made informed choices about cancer screening tests. They were also more likely to say their doctor did not give them some control of their tests. Patients with educational levels above an associate degree felt better about their screening decisions and more certain of the benefits than less-educated patients.
The researchers recommend that physicians consider racial differences when tailoring cancer screenings and that they make a special effort to involve men, blacks, and less-educated patients in these discussions. The study was supported in part by the Agency for Healthcare Research and Quality (HS13521).
See "Perceptions of informed decision making about cancer screening in a diverse primary care population," by Margaret L. Gourlay, M.D., M.P.H., Carmen L. Lewis, M.D., M.P.H., John S. Preisser, Ph.D., and others in the June 2010 Family Medicine 42(6), pp. 421-427.