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Conversations about Screening Tests

Posted 6/22/2014

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  For most of us, conversations with our doctor(s) about screening tests mean annual mammograms, possibly annual breast MRIs, periodic colonoscopies, and annual dermatology appointments to look for worrisome moles. These same conversations happen with people who have not had cancer, but they likely assume a different urgency for us. Once cancer has happened, we are all too aware that it could happen again, and these tests are very real, not just a theoretical concern.

  This recent article from The American Journal of Preventive Medicine talks about the recent paradign shift that encourages shared decision making between doctors and patients. It also, to my horror, indiciates that more substantive conversations are likely to occur when the patient is a man rather than a woman. Remembering that the cited study was not only about cancer patients, I surely hope this would not be the case in oncology settings.

  The take home lesson, I think, is that these conversations are important, and that your wishes need to be part of the equation and the decisions. Here is the beginning and a link to read more. The body of the article from Medscape contains a link to the study itself if you want to read the original.

Doctor-Patient Cancer Screening Talks: Often Not Ideal
Veronica Hackethal, MD

Doctor–patient discussions about cancer screening tests often fall short of an informational ideal, especially when the patient is a woman, according to a study of patient-reported experiences.
Overall, the talks rarely address the harms of testing, and only about a third of discussions meet established criteria for shared decision making (SDM).
Such a talk consists of informing patients about the need for a decision, inviting participation, presenting the benefits and harms, and helping patients achieve decisions "concordant with their personal values," write the authors, led by Richard M. Hoffman, MD, MPH, professor of medicine at the University of New Mexico School of Medicine in Albuquerque.
Notably, the study showed that discussions with women are of lower quality than those with men. And women's preferences were considered less often than men's.
The study was published online June 8 in the American Journal of Preventive Medicine.


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