Knowledge Of Cancer Screening Guidelines Research Articles

Association Between Adherence to Cancer Screening and Knowledge of Screening Guidelines: Feasibility Study Linking Self-Reported Survey Data With Medical Records.

BackgroundIt is possible that patients who are more aware of cancer screening guidelines may be more likely to adhere to them.ObjectiveThe aim of this study was to determine whether screening knowledge was associated with the documented screening participation. We also assessed the feasibility and acceptability of linking electronic survey data with clinical data in the primary care setting.MethodsWe conducted an electronic survey at 2 sites in Toronto, Canada. At one site, eligible patients were approached in the waiting room to complete the survey; at the second site, eligible patients were sent an email inviting them to participate. All participants were asked to consent to the linkage of their survey results with their electronic medical record.ResultsOverall, 1683 participants responded to the survey—247 responded in the waiting room (response rate, 247/366, 67.5%), whereas 1436 responded through email (response rate, 1436/5779, 24.8%). More than 80% (199/247 and 1245/1436) of participants consented to linking their survey data to their medical record. Knowledge of cancer screening guidelines was generally low. Although the majority of participants were able to identify the recommended tests for breast and cervical screening, very few participants correctly identified the recommended age and frequency of screening, with a maximum of 22% (21/95) of screen-eligible women correctly answering all 3 questions for breast cancer screening. However, this low level of knowledge among patients was not significantly associated with screening uptake, particularly after adjustment for sociodemographic characteristics.ConclusionsAlthough knowledge of screening guidelines was low among patients in our study, this was not associated with screening participation. Participants were willing to link self-reported data with their medical record data, which has substantial implications for future research.

Comparative Effectiveness of Audit-Feedback Versus Additional Physician Communication Training to Improve Cancer Screening for Patients with Limited Health Literacy

We designed a continuing medical education (CME) program to teach primary care physicians (PCP) how to engage in cancer risk communication and shared decision making with patients who have limited health literacy (HL). We evaluated whether training PCPs, in addition to audit-feedback, improves their communication behaviors and increases cancer screening among patients with limited HL to a greater extent than only providing clinical performance feedback. Four-year cluster randomized controlled trial. Eighteen PCPs and 168 patients with limited HL who were overdue for colorectal/breast/cervical cancer screening. Communication intervention PCPs received skills training that included standardized patient (SP) feedback on counseling behaviors. All PCPs underwent chart audits of patients' screening status semiannually up to 24 months and received two annual performance feedback reports. PCPs experienced three unannounced SP encounters during which SPs rated PCP communication behaviors. We examined between-group differences in changes in SP ratings and patient knowledge of cancer screening guidelines over 12 months; and changes in patient cancer screening rates over 24 months. There were no group differences in SP ratings of physician communication at baseline. At follow-up, communication intervention PCPs were rated higher in general communication about cancer risks and shared decision making related to colorectal cancer screening compared to PCPs who only received performance feedback. Screening rates increased among patients of PCPs in both groups; however, there were no between-group differences in screening rates except for mammography. The communication intervention did not improve patient cancer screening knowledge. Compared to audit and feedback alone, including PCP communication training increases PCP patient-centered counseling behaviors, but not cancer screening among patients with limited HL. Larger studies must be conducted to determine whether lack of changes in cancer screening were due to clinic/patient sample size versus ineffectiveness of communication training to change outcomes.

Do Patients in a Primary Care Practice Know the Current Cancer Screening Guidelines?

Background: In spite of supporting evidence and widespread promotional campaigns, screening rates for breast, cervical and colorectal cancers in Ontario are lower than expected. These low screening rates may be partially due to lack of knowledge on the part of patients. Given the importance of early detection to reduce cancer mortality and morbidity, it is prudent to investigate where knowledge deficits may exist. The purpose of this study was to assess patient knowledge of the Ontario screening guidelines for breast, cervical and colorectal cancers. Methods: Patients of a family health team in Toronto, Ontario were surveyed regarding their knowledge of cancer screening guidelines. Questions included knowledge regarding the test, screening interval and age for cancer screening for breast, cervical and colorectal cancers as well as sociodemographic characteristics. Responses were summarized using descriptive statistics. Results: A total of 117 patients were surveyed. Knowledge of the appropriate screening test was high for breast and cervical cancer (85.5% and 70.1% respectively) though much lower for colorectal cancer (17.1%). Knowledge regarding the age that screening should occur and the screening intervals were much lower across all cancer types. For breast cancer, 16.2% knew the age screening should occur and 30.8% knew the screening interval. For cervical cancer, 6.8% knew the age screening should occur and only 4.3% knew the screening interval. For colorectal cancer, 32.5% knew the age to start screening and 26% knew the screening interval. Conclusions: Knowledge of the cancer screening guidelines appeared to be low across all cancer types, particularly for the ages at when screening should occur and the appropriate screening intervals. These results suggest that public health practitioners and cancer prevention organizations may need to increase efforts for patient education on cancer screening.