Decision making in early-stage colorectal cancer treatments: a literature review

Abstract

Background: The introduction of the National Bowel Cancer Screening Programme has led to an increase in colorectal cancer diagnosed at an early stage. Advances in the options for treatmentof early-stage disease may have similar survival benefits but different risks and side effects. The decision on treatment for early stage bowel cancers can therefore be described as preference sensitive. Method: A literature review was conducted of 12 studies and reviews published 2007–2017, focusing on patient involvement in decisions on treatment following a diagnosis of colorectal cancer. The review covered both patient and clinician perspectives. Results: The review highlighted key themes that influence how far patients are involved in decisions regarding treatment. These themes include: patient understanding of the preference-sensitive nature of the decision, time pressures and perceived inapplicability of involving patients. Conclusion: Further studies are necessary to understand the experiences of patients and clinicians making treatment decisions in the context of early colorectal cancer, including polyp cancers. There is a lack of studies specifically addressing clinician experiences in this area.