Does information about risks and benefits improve the decision-making process in cancer screening - Randomized study

Background: Whether the provision of evidence-based information improves satisfaction with decision-making is unclear. Objective: To examine whether information about risks and benefits of cancer screening leads to a higher satisfaction with the decision that was made. Methods: Randomized mail survey in the general population, among 2333 adults aged 30-60 years. The survey included a hypothetical cancer screening scenario that included varying amounts of information about benefits and risks of screening (factorial randomized design). The decision process was evaluated by a 6 item scale, with scores between 0 (lowest score) and 100 (highest score). Results: Substantial proportions of respondents “completely agreed” that the decision reflected what was most important to them (61.2%), were satisfied with their decision (56.0%), were certain of their decision (54.1%), thought that the best choice for them was obvious (53.5%) and that the decision was easy to make (44.1%). The Cronbach alpha coefficient of the scale was 0.88, the mean score was 82.5, and the standard deviation 17.5. Providing information about benefits increased the decision evaluation score only modestly (+1.1, p = 0.11); in contrast, providing information about risks sharply reduced the score (−5.1, p < 0.001). Those who refused the screening test had lower scores than those who accepted the screening test (69.2 versus 85.6, p < 0.001). Conclusions: Contrary to expectations, informing potential participants about the risks of cancer screening lowered their assessment of the decision process.