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Many Veterans Oppose Cessation of Colorectal Cancer Screening

FRIDAY, Dec. 28, 2018 -- Many veterans have strong preferences against colorectal cancer (CRC) screening cessation even when provided with information about the potential low benefit of screening, according to a study published online Dec. 7 in JAMA Network Open.

Marc S. Piper, M.D., from the Michigan State University College of Human Medicine in Southfield, and colleagues surveyed 1,054 patients >50 years who had undergone prior screening colonoscopy with normal results at the Veterans Affairs Ann Arbor Healthcare System to assess veterans' attitudes toward and comfort with cessation of low-value CRC screening.

The researchers found that 28.7 percent of respondents were not at all comfortable with cessation of low-value CRC screening. Nearly half (49.3 percent) thought that age should never be used to decide when to stop screening, while 31.7 percent thought it was not at all reasonable to use life expectancy calculators to guide these decisions and 24.3 percent thought it was not reasonable to use CRC risk calculators. Factors associated with greater comfort with stopping screening included: higher trust in physician (odds ratio [OR], 1.19), higher perceived health status (OR, 1.41), and higher barriers to screening (OR, 1.2). In contrast, factors associated with less comfort with screening cessation included greater perceived effectiveness of screening (OR, 0.86) and greater perceived threat of CRC (OR, 0.81).

"We need to build the bridge between how we think about screening as experts, based on data and overall benefit, and how our patients think about screening, which is often driven by emotion and other core beliefs," Piper said in a statement.

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Posted: December 2018

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