Assessing the quality of cancer screening leaflets using the International Patient Decision Aids Standards instrument: A cross-sectional content analysis

• Published in: Patient education and counseling 2021-12, Vol.104 (12), p.3100-3103
• Main Authors: Furukawa, Yuki, Saito, Hiroko, Hasegawa, Kazuo, Ichikawa, Mamoru
• Format: Article
• Language: English
• Subjects: Autonomy; Cross-Sectional Studies; Decision Making; Decision Support Techniques; Early Detection of Cancer; Health promotion; Humans; Informed consent; Mass Screening; Neoplasms - diagnosis; Patient and public involvement; Patient Participation; Risk communication; Shared decision making
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2021.03.034

•Cancer screening programs should be evaluated by the quality of informed-decision.•We assessed leaflets used nationwide in Japan with a standardized measure.•They did not provide enough information to make an informed choice.•Evidence-based, well-balanced, easy-to-understand information should be provided. To assess the quality of national cancer screening program leaflets in Japan from the informed-decision perspective. Cross-sectional content analysis of invitation leaflets issued by centralized organizations and used nationwide in Japan was conducted. Three members independently evaluated the materials using International Patient Decision Aids Standards six-item minimum criteria for qualifying patient decision aids. Co-author KH is a cancer patient himself. We also sought feedbacks from three other cancer survivors and two bereaved family members. Inter-rater agreement was substantial (Fleiss’ kappa=0.62). The median score was 2 out of 6 (range: 2–3). All leaflets described the cancer (Q1: 7/7) and screening modality (Q2: 7/7). None stated not undergoing screening as an option. One stated another screening modality (Q3: 1/7). None stated both the positive and negative features of multiple options (Q4: 0/7. Q5: 0/7). One described the psychological and social experience of screening but only its positive side (Q6: 1/7). There is room for improvement in the content of the public cancer screening invitation leaflets in Japan from informed-decision perspective. Cancer screening leaflets should provide evidence-based, well-balanced, easy-to-understand information to educate people on cancer screening while maintaining people’s autonomy.