Article type
Abstract
Background
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. Patients with CRC experience high psychological and physical burden at different stages of the disease. Understanding how individuals value outcomes resulting from CRC diagnosis may help estimate the benefit from CRC diagnostic tests and develop trustworthy recommendations.
Objectives
We aimed to evaluate (i) values and preferences of average-risk adults concerning the outcomes arising from CRC diagnosis and (ii) how individuals diagnosed with CRC value their health states at different stages of the disease.
Methods
We conducted a mixed-methods systematic review based on guidance from Joanna Briggs Institute and Cochrane. We registered the protocol on the OSF platform. We searched MEDLINE, EMBASE, PsycINFO, and CINAHL with no date restrictions. We included qualitative or quantitative studies conducted in Europe published in English as full-text articles with average risk, asymptomatic adults.
Results
We included 47 reports, with 27,693 participants. We found high-certainty evidence that (i) people place high value on detecting lesions quickly and (ii) people with late-stage CRC rate their utility between 0.59 and 0.82. We found moderate-certainty evidence that (i) people place low value on avoiding false positive screening results, (ii) people place a high value in avoiding false negative screening results, (iii) people place high importance in avoiding recall for assessment and prefer shorter waits for follow-up colonoscopies, (iv) stress and anxiety caused by fear of cancer or embarrassment of undergoing tests are probably a catalyst for undergoing tests for some people and inhibit participation for others.
Conclusions
People at average risk of CRC place high value on early detection and avoiding false negative results while placing a low value on false positives. People place high importance in avoiding recall for assessment and prefer shorter waiting times for follow-up colonoscopies. Negative emotions related to the test probably influence people's decision to undergo diagnostic tests. After diagnosis, burden is progressive, and late-stage CRC has moderate impact on people’s lives.
Relevance
These findings on how people value the outcomes of interest may help develop tailored strategies for the implementation of recommendations.
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. Patients with CRC experience high psychological and physical burden at different stages of the disease. Understanding how individuals value outcomes resulting from CRC diagnosis may help estimate the benefit from CRC diagnostic tests and develop trustworthy recommendations.
Objectives
We aimed to evaluate (i) values and preferences of average-risk adults concerning the outcomes arising from CRC diagnosis and (ii) how individuals diagnosed with CRC value their health states at different stages of the disease.
Methods
We conducted a mixed-methods systematic review based on guidance from Joanna Briggs Institute and Cochrane. We registered the protocol on the OSF platform. We searched MEDLINE, EMBASE, PsycINFO, and CINAHL with no date restrictions. We included qualitative or quantitative studies conducted in Europe published in English as full-text articles with average risk, asymptomatic adults.
Results
We included 47 reports, with 27,693 participants. We found high-certainty evidence that (i) people place high value on detecting lesions quickly and (ii) people with late-stage CRC rate their utility between 0.59 and 0.82. We found moderate-certainty evidence that (i) people place low value on avoiding false positive screening results, (ii) people place a high value in avoiding false negative screening results, (iii) people place high importance in avoiding recall for assessment and prefer shorter waits for follow-up colonoscopies, (iv) stress and anxiety caused by fear of cancer or embarrassment of undergoing tests are probably a catalyst for undergoing tests for some people and inhibit participation for others.
Conclusions
People at average risk of CRC place high value on early detection and avoiding false negative results while placing a low value on false positives. People place high importance in avoiding recall for assessment and prefer shorter waiting times for follow-up colonoscopies. Negative emotions related to the test probably influence people's decision to undergo diagnostic tests. After diagnosis, burden is progressive, and late-stage CRC has moderate impact on people’s lives.
Relevance
These findings on how people value the outcomes of interest may help develop tailored strategies for the implementation of recommendations.