title: Informed decision-making in colorectal cancer screening using colonoscopy or CT-colonography.
abstract: OBJECTIVE
  To evaluate the level of informed decision making in a randomized controlled trial comparing colonoscopy and CT-colonography for colorectal cancer screening.
  
  
  METHODS
  8844 citizens aged 50-75 were randomly invited to colonoscopy (n=5924) or CT-colonography (n=2920) screening. All invitees received an information leaflet. Screenees received a questionnaire within 4 weeks before the planned examination, non-screenees 4 weeks after the invitation. A decision was categorized as informed when characterized by sufficient decision-relevant knowledge and consistent with personal attitudes toward participation in screening.
  
  
  RESULTS
  Knowledge and attitude items were completed by 1032/1276 colonoscopy screenees (81%), by 698/4648 colonoscopy non-screenees (15%), by 824/982 CT-colonography screenees (84%) and by 192/1938 CT-colonography non-screenees (10%). 1027 colonoscopy screenees (>99%) and 815 CT-colonography screenees (99%) had adequate knowledge; 915 (89%) and 742 (90%) had a positive attitude. 675 non-screenees invited to colonoscopy (97%) and 182 invited to CT-colonography (95%) had adequate knowledge; 344 (49%) and 94 (49%) expressed a negative attitude.
  
  
  CONCLUSIONS
  A large majority of screenees made an informed decision on participation. Almost half of responding non-screenees, made an uninformed decision, suggesting additional barriers to participation.
  
  
  CONCLUSIONS
  Efforts to understand the additional barriers will create opportunities to facilitate informed participation to colorectal cancer screening.
authors: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands. margrietcdehaan@gmail.com
authors: Margriet C
authors: MC
authors: de Haan
authors: Thomas R
authors: TR
authors: de Wijkerslooth
authors: Esther
authors: E
authors: Stoop
authors: Patrick
authors: P
authors: Bossuyt
authors: Paul
authors: P
authors: Fockens
authors: Maarten
authors: M
authors: Thomeer
authors: Ernst J
authors: EJ
authors: Kuipers
authors: Marie-Louise
authors: ML
authors: Essink-Bot
authors: Monique E
authors: ME
authors: van Leerdam
authors: Evelien
authors: E
authors: Dekker
authors: Jaap
authors: J
authors: Stoker
mesh_terms: D000368:Aged; D023881:Colonography, Computed Tomographic / Q000379:methods / Q000706:statistics & numerical data*; D003113:Colonoscopy / Q000379:methods / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003657:Decision Making; D055088:Early Detection of Cancer; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic; D012042:Registries; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires