Web sites can give patients info they need for decisions

Credible Internet resources were found to be helpful for patients needing to make informed choices on cancer screening.

By Susan J. Landers — Posted Jan. 26, 2004

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Washington -- Physicians know these patients. They are the ones who bring pages and pages of Internet printouts to office visits. A new report concluded they may actually be saving the physician precious time by doing so -- at least when it comes to helping the patients sort through the pros and cons of cancer screenings.

The report, authored by the Task Force on Community Preventive Services and published in the January American Journal of Preventive Medicine, found that connecting patients to reliable Internet resources or handing them brochures on cancer screening does help them to make appropriate decisions. And if patients tap into this vast repository of health information on their own, it may well free up some time during ever-briefer office visits for physicians to discuss more patient-specific concerns.

Overall, the task force, an independent panel supported by the Centers for Disease Control and Prevention, reviewed 11 studies with 15 investigational arms and found that brochures and Web-based information that individuals access independently can help them make good individual choices about cancer screening, including whether to be screened at all.

"We know that making decisions about cancer screening can be difficult for individuals and their families," said CDC Director Julie Gerberding, MD, MPH.

"These findings from the task force provide important insight about how public health can communicate effectively about the risks, benefits and other outcomes associated with screening," she said.

Decisions on screenings have become more complex in recent years with research supporting some tests, for example screening for colon cancer, while remaining less clear about others, such as prostate cancer screening. And sometimes, as is the case with colon cancer, there are several tests from which patients and physicians have to choose.

The gift of time

The review also pointed to a bonus for physicians. "We think it is unreasonable to expect heroic providers one at a time to provide patients with all the information that they need in the context of a 15-minute office visit," said Peter Briss, MD, MPH, chief of the CDC's community guide branch.

The growing tendency by patients to research health topics on the Internet helped prompt his division to sponsor an examination of "informed decision-making."

Informed decision-making occurs when individuals have enough information about a disease, the screening test for it and their personal risk level to make a choice that reflects their preferences and values and allows them to participate in decision-making at the level they choose, according to the CDC.

"We found that [it] could improve patients' knowledge and risk perception," said Dr. Briss. "We needed to know more about whether the kinds of interventions could help people get involved in the decision-making at the level that they wanted."

Although informed decision-making can apply to the entire range of medical options, the task force turned to cancer screening because there is a great deal of interest in the area, he said.

There is also likely to be continued interest in cancer screening as genetic testing comes down the pipeline, he added.

The community preventive services task force has completed nearly 90 reports covering such issues as vaccine-preventable diseases; tobacco use, prevention and control; the reduction of motor vehicle injuries and cancer. It was established in 1996 as the community-based counterpart to the U.S. Preventive Services Task Force, which focuses on clinical preventive services.

While the panel already publishes its findings in a variety of journals and on its Web site, the intention is to publish a compilation of its reports in book version later this year, said Dr. Briss.

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External links

Guide to Community Preventive Services (link)

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