Review: personalised risk communication may improve uptake of screening tests more than general risk communication

摘要

The systematic review by Edwards ef al provides insight into how different methods of communicating risks and benefits to individuals affect whether or not they subsequently uptake screening. This is in contrast to previous reviews that have focused on how more general interventions affect screening uptake.The authors used a comprehensive search strategy, clear inclusion criteria, and 2 checklists to assess methodological quality of individual studies. The results are interesting, in that increased screening uptake with PRC appears to be dependent on how PRC is presented. Communication of risk in precise numerical terms or in categories (low, medium, and high risk) resulted in lower uptake than communication of risk in more general terms. When individuals were given a list of their risk factors as the basis of discussion, but not precise values, they were more likely to uptake screening. However, a cautionary note must be added about the interpretation of these findings because of the small number of studies and the limited variety of screening programmes that were included. Only 5 of the 10 studies included in the analysis used this type of intervention, and most examined breast cancer screening.Practitioners who counsel patients about the risks and benefits of screening may find these results useful. They should be aware of the potential effects of presenting PRC in different ways and the subsequent effect this may have on screening uptake. In light of the findings of this review, further research is needed on the presentation of risk information and its effects on individual behaviour. In particular, examining whether particular types of PRC are more or less beneficial for different screening decisions may be appropriate.