Monday, August 19, 2013

Doctors do not always discuss not fully the risks and benefits of screening for cancer

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Doctors do not always discuss not fully the risks and benefits of screening for cancer -

A national survey of patients shows that doctors do not always discuss not fully the risks and benefits of cancer screening, reports a new study American Journal of Preventive Medicine .

The study examined data from more than 1,100 people aged 50 and over who have made decisions on whether to undergo breast cancer screening, colorectal cancer, or cancer of the prostate during the previous 2 years. Participants were asked if their doctors discussed the pros and cons of testing and waive testing, and if they were given a choice whether or not to be screened.

shared decision making was reported by only 27 percent of women for breast cancer screening, 38 percent of men and women for colorectal screening, and 34 percent for men screening for prostate. Survey participants indicated that physicians were more likely to discuss the benefits of a given screening procedure (51 percent to 67 percent, depending on the type of screening) and cons (7 percent to 14 percent) . In addition, most doctors have offered opinions that mainly favored screening.

The doctors were also reported to be more likely to ask men (71 percent for colorectal cancer and 70 percent for prostate cancer) they wanted to test than they 'were to ask women (43 percent for breast cancer and 57 percent for colorectal cancer).

Ideally, shared decision making, a doctor informs a patient that a decision is necessary, invite them to influence the decision, and provide it with information on the risks and benefits of both tests / treatment or do nothing. Ideally, the doctor also helps the patient to make a decision that considers the values ​​and preferences of the patient about their health and health care.

Overall, 77 percent of patients decided to participate in the three projections of cancer studied, ranging from 69 percent of women for colorectal cancer in 93 percent of men for prostate cancer . The majority said they were confident about their decision; However, those who said their doctors were primarily responsible for the decision were less confident than those taking a split decision.

The authors also compared to discussions with women in their 40s compared to women over 50 because of the recent controversy split decision on the relevance of breast cancer screening for younger women and were surprised by the result.

"We expected that would make the quality better for young women decision and it was not," said Richard M. Hoffman, MD, MPH, professor of internal medicine at University of New Mexico in Albuquerque of medicine and lead author of the study. "overall, we do not see the decision much shared."

"the methodology [the authors] used and their interpretation of the data is correct, "said Richard Wender, MD, chief of the fight against cancer with the American cancer Society in Atlanta and co-author of the guidelines that lead to screening for prostate cancer decision shared. However, he said that extrapolating from the results must be made with caution. "Medicine will discuss what types of doctor's advice should be moved in shared decision making as opposed to traditional recommendations to have done," he said.

"shared decision making is hard to do, "Wender added." Tools and tips on how to do so are not as readily available as they should. "


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