The CRISP-Q study: communicating the risks and benefits of colorectal cancer screening

Background and objectives: Many Australians at average risk of colorectal cancer (CRC) are undergoing unnecessary colonoscopic screening, while many at increased risk are getting inadequate screening. The aim of this study was to test different ways of communicating the risks and benefits of CRC screening, as part of the development of a CRC risk prediction (CRISP) tool. 

Method: General practice patients were shown five different risk presentations for hypothetical ‘average’ and ‘increased’ risk cases and were asked to choose the screening method they would undergo. Associations were explored between risk presentation type and ‘risk-appropriate screening’ choice. 

Results: All risk formats were associated with improved risk-appropriate screening by participants (n = 204); however, there was a statistical trend favouring absolute risk with a government recommendation and an ‘expected frequency tree’. The icon array was most weakly associated with appropriate screening. 

Discussion: This research will inform approaches to communicating risk in CRISP and may be of wider relevance to supporting informed decisions about cancer screening.