title: Knowledge and values for cancer screening decisions: Results from a national survey.
abstract: BACKGROUND
  Guidelines recommend shared decision making (SDM) for cancer screening decisions. SDM requires providers to ensure that patients are informed about screening issues and to support decisions that are concordant with patient values. We evaluated decision-quality factors for breast, colorectal, and prostate cancer screening decisions.
  
  
  METHODS
  We conducted a national, population-based Internet survey of adults aged 40+ to characterize perceptions about about cancer screening, the importance of information sources, cancer screening knowledge, values and preferences for screening, and the most influential drivers of decisions.
  
  
  RESULTS
  Among 1452 participants who completed the survey, the mean age was 60, and 94% were insured. Most participants reported feeling well informed about cancer screening, though only 21% reported feeling extremely well informed. Most participants correctly answered about 50% of the knowledge questions, with the majority markedly overestimating lifetime risk of cancer diagnoses and mortality. Participants rated health care providers as the most important source of information.
  
  
  CONCLUSIONS
  Although respondents considered themselves well informed about cancer they performed poorly on knowledge questions. This discordance suggests the potential for poor-quality decision making.
  
  
  CONCLUSIONS
  To improve the quality of decision making, providers need training to utilize decision support tools and time to carry out SDM.
authors.affiliation: Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States; Medicine Service, Iowa City VA Medical Center, Iowa City, IA, United States.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Hoffman
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States.
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
authors.affiliation: University of North Carolina Division of General Internal Medicine, Chapel Hill, NC, United States; University of North Carolina Institute for Healthcare Quality Improvement, Chapel Hill, NC, United States.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Pignone
authors.affiliation: Informed Medical Decisions Foundation, Division of Healthwise, Inc. Boston, MA, United States.
authors.forename: Bethany S
authors.initials: BS
authors.lastname: Gerstein
authors.affiliation: Informed Medical Decisions Foundation, Division of Healthwise, Inc. Boston, MA, United States.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Levin
authors.affiliation: Department of Medicine and Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, United States. Electronic address: fairfk@mmc.org.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Fairfield
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D010358:Patient Participation; D011795:Surveys and Questionnaires
keywords: Cancer screening; Informed decisions