title: Effects of personalized colorectal cancer risk information on laypersons' interest in colorectal cancer screening: The importance of individual differences.
abstract: OBJECTIVE
  To evaluate how personalized quantitative colorectal cancer (CRC) risk information affects laypersons' interest in CRC screening, and to explore factors influencing these effects.
  
  
  METHODS
  An online pre-post experiment was conducted in which a convenience sample (N=578) of laypersons, aged >50, were provided quantitative personalized estimates of lifetime CRC risk, calculated by the National Cancer Institute Colorectal Cancer Risk Assessment Tool (CCRAT). Self-reported interest in CRC screening was measured immediately before and after CCRAT use; sociodemographic characteristics and prior CRC screening history were also assessed. Multivariable analyses assessed participants' change in interest in screening, and subgroup differences in this change.
  
  
  RESULTS
  Personalized CRC risk information had no overall effect on CRC screening interest, but significant subgroup differences were observed. Change in screening interest was greater among individuals with recent screening (p=.015), higher model-estimated cancer risk (p=.0002), and lower baseline interest (p<.0001), with individuals at highest baseline interest demonstrating negative (not neutral) change in interest.
  
  
  CONCLUSIONS
  Effects of quantitative personalized CRC risk information on laypersons' interest in CRC screening differ among individuals depending on prior screening history, estimated cancer risk, and baseline screening interest.
  
  
  CONCLUSIONS
  Personalized cancer risk information has personalized effects-increasing and decreasing screening interest in different individuals.
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, USA. Electronic address: hanp@mmc.org.
authors.forename: Paul K J
authors.initials: PK
authors.lastname: Han
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, USA.
authors.forename: Christine W
authors.initials: CW
authors.lastname: Duarte
authors.affiliation: Tufts University, Medford, MA, USA.
authors.forename: Susannah
authors.initials: S
authors.lastname: Daggett
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Siewers
authors.affiliation: User-Centered Design, Ashburn, VA, USA.
authors.forename: Bill
authors.initials: B
authors.lastname: Killam
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, USA.
authors.forename: Kahsi A
authors.initials: KA
authors.lastname: Smith
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Freedman
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055088:Early Detection of Cancer; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007206:Individuality; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care
keywords: Colorectal cancer; Personalized risk information; Screening