Interventions Affect Patients’ Cancer Screening Intentions

Patients shown video presentations about prostate and breast cancer screening may change their mind about undergoing the procedure.

Fewer men and women wanted prostate or breast cancer screening after viewing a video regarding the limits and harms associated with the exams, according to a study published in the Annals of Family Medicine.

Researchers from Massachusetts and Washington evaluated novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 (from 2009).

The researchers developed a presentation in which physicians and patients discussed prostate cancer screening and mammography. The presentations included patient/physician discussions and illustrative sides. A crossover study included 27 men (aged 50 to 74) and 35 women (aged 40 to 49) who watched a video intervention or were provided with a more traditional, paper-based decision aid intervention. Each subject was asked about screening intentions, perceptions of benefits and harm, and decisional conflict before and after the intervention.

The results showed that before the interventions, 69% of men and 86% of women had reported wanting screening and 31% and 6%, respectively, were unsure. Mean change on a 3-point, yes, unsure, no scale was −0.93 for men and −0.50 for women after seeing the video interventions versus 0.0 and −0.06 after seeing the print interventions. After the interventions, 33% of men and 49% of women wanted screening, and 11% and 20%, respectively, were unsure.

The researchers concluded that their “persuasive video interventions significantly changed the screening intentions of substantial proportions of viewers. Our approach needs further testing but may provide a model for helping patients to consider and accept evidence-based, counterintuitive recommendations.”