Patients' experiences and reported barriers to colonoscopy in the screening context--a systematic review of the literature.

Objective: A systematic review of the literature was conducted to characterise patients' own experience of colonoscopy in the screening context.

Methods: A search strategy was applied in MEDLINE, EMBASE and PSYCHinfo (1996-2009). Thematic analysis and narrative summary techniques were used.

'A false sense of security'? Understanding the role of the HPV vaccine on future cervical screening behaviour: a qualitative study of UK parents and girls of vaccination age.

Objectives: The UK Human Papillomavirus (HPV) vaccination programme was introduced in 2008 for girls aged 12-13. The vaccine offers protection against HPV types 16 and 18, which together cause about 70% of cervical cancers. Vaccinated girls will receive future invitations to the NHS Cervical Screening Programme, to prevent cancers associated with HPV types not included in the vaccine, and in case of prior infection with HPV 16 or 18.

Women's preferences for the delivery of the National Health Service Breast Screening Programme: a cross-sectional survey.

Objective: To elicit women's preferences for delivery of the National Health Service (NHS) Breast Screening Programme.

Design: Interview survey.

Setting: Private households in the UK.

Clinicians' concerns about decision support interventions for patients facing breast cancer surgery options: understanding the challenge of implementing shared decision-making.

Background: There is interest in interventions that provide support for patients facing challenging decisions, such as the choice between mastectomy and breast conservation surgery for breast cancer. However, it is difficult to implement these interventions. One potential source of resistance is the attitudes of clinicians.

Ethnic disparities in knowledge of cancer screening programmes in the UK.

Objective: The aim of the study was to examine awareness of the three National Cancer Screening Programmes (breast, cervical, bowel) among white and ethnic minority groups in the UK.

Setting: Data were from two surveys in which the screening questions were added: (i) the Office of National Statistics (ONS) Opinions Survey, carried out in September and October 2008; and (ii) the Ethnibus™ survey of the main ethnic minority groups in England, conducted in October and November 2008.

Methods: The ONS sample consisted of 2216 adults selected using stratified probability sampling to obtain a population-representative sample.

Improving the quality of communication in organised cervical cancer screening programmes.

Objective: To provide health professionals involved in cervical cancer screening with an insight into the complex issues relating to communication about screening and to provide a framework for a more effective communication strategy.

Methods: This paper has been compiled by a multidisciplinary pan-European group of health professionals and cancer advocates from several European screening programmes. European surveys on screening communication, literature reviews and group discussion were used for this purpose.

Public perceptions of communicating information about bowel cancer screening.

Objectives: The National Health Service has recently begun the introduction of a Bowel Cancer Screening Programme (BCSP), offering biennial screening to men and women aged 60-69 years. This study aimed to explore public perceptions regarding the communication of information designed to facilitate informed choice in relation to this new screening programme.

Methods: Fourteen single sex focus groups were conducted in England with 86 individuals aged 60-69 years.

Long-term survivors of adult cancers and uptake of primary health services: a systematic review.

Aim: The aim of this paper is to systematically review the literature on the use of primary and community care services by long-term survivors of adult cancers.

Methods: We conducted a systematic search of eight databases and considered papers looking at primary care aspects of surviving cancer at least 3 years past diagnosis.

Results: Ten eligible papers in four categories: consultation rates in primary care, cancer screening, use of preventative services and chronic disease management.

A randomised controlled trial of the effects of a web-based PSA decision aid, Prosdex. Protocol.

Background: Informed decision making is the theoretical basis in the UK for men's decisions about Prostate Specific Antigen (PSA) testing for prostate cancer testing. The aim of this study is to evaluate the effect of a web-based PSA decision-aid, Prosdex, on informed decision making in men. The objective is to assess the effect of Prosdex on six specific outcomes: (i) knowledge of PSA and prostate cancer-related issues - the principal outcome of the study; (ii) attitudes to testing; (iii) decision conflict; (iv) anxiety; (v) intention to undergo PSA testing; (vi) uptake of PSA testing.

What is the psychological impact of mammographic screening on younger women with a family history of breast cancer? Findings from a prospective cohort study by the PIMMS Management Group.

Purpose: Studies are underway to establish the clinical effectiveness of annual mammographic screening in women younger than 50 years with a family history of breast cancer. This study investigated both the positive and negative psychological effects of screening on these women.

Patients And Methods: Women who received an immediate all-clear result after mammography (n = 1,174) and women who were recalled for additional tests before receiving an all-clear result (false positive; n = 112) completed questionnaires: 1 month before mammography, and 1 and 6 months after receiving final results.

What influences men's decision to have a prostate-specific antigen test? A qualitative study.

Background: Current UK policy recommends informed decision making for prostate-specific antigen (PSA) testing. The process by which men decide to be tested warrants further investigation.

Objective: To determine the important influences on men's decision to have a PSA test.

Toward a model for field-testing patient decision-support technologies: a qualitative field-testing study.

Background: Field-testing is a quality assurance criterion in the development of patient decision-support technologies (PDSTs), as identified in the consensus statement of the International Patient Decision Aids Standards Collaboration. We incorporated field-testing into the development of a Web-based, prostate-specific antigen PDST called Prosdex, which was commissioned as part of the UK Prostate Cancer Risk Management Programme.

Objectives: The aim of this study was to develop a model for the future field-testing of PDSTs, based on the field-testing of Prosdex.

The PSA testing dilemma: GPs' reports of consultations with asymptomatic men: a qualitative study.

Background: The National Health Service Prostate Cancer Risk Management Programme (PCRMP) has recommended that screening for prostate cancer is available for asymptomatic men, on the understanding that they have been provided with full and balanced information about the advantages and limitations of the prostate-specific antigen (PSA) test. Guidance has been distributed to all GPs in England and Wales to assist in the provision of information to men. This study aimed to elicit GPs' accounts of their discussions with asymptomatic men who consult with concerns about prostate cancer in order to identify the degree to which the PCRMP guidance was reflected in these consultations.

"It's a maybe test": men's experiences of prostate specific antigen testing in primary care.

Background: Prostate specific antigen (PSA) testing in primary care is an important and contentious issue. Due to concerns about the test and the value of early detection, countries such as the UK advocate 'informed choice' instead of population screening. It is not known whether this policy is actually adhered to in primary care.

Information and cervical screening: a qualitative study of women's awareness, understanding and information needs about HPV.

Objectives: To explore women's attitudes towards the information about human papilloma virus (HPV) provided during cervical screening and to describe women's HPV information needs.

Setting: Women with a range of screening results (normal, inadequate, borderline and abnormal) were identified by three screening centres in England. Two consecutive samples of women attending for colposcopy for the first time following screening were also approached.

Does the English Breast Screening Programme's information leaflet improve women's knowledge about mammography screening? A before and after questionnaire survey.

Objectives: To explore whether the English Breast Screening Programme's leaflet improved women's knowledge of breast cancer screening. Design Before and after postal questionnaire survey. Participants A random sample of 100 women aged between 49 and 64 years registered with GPs in Oxfordshire on whom data from a prospective, questionnaire survey was available on knowledge and perception of breast cancer screening.

Synthesising quantitative and qualitative research in evidence-based patient information.

Background: Systematic reviews have, in the past, focused on quantitative studies and clinical effectiveness, while excluding qualitative evidence. Qualitative research can inform evidence-based practice independently of other research methodologies but methods for the synthesis of such data are currently evolving. Synthesising quantitative and qualitative research in a single review is an important methodological challenge.

A systematic review of information in decision aids.

Objective: We completed a systematic review of information reported as included in decision aids (DAs) for adult patients, to determine if it is complete, balanced and accurate.

Search Strategy: DAs were identified using the Cochrane Database of DAs and searches of four electronic databases using the terms: 'decision aid'; shared decision making' and 'patients'; 'multimedia or leaflets or pamphlets or videos and patients and decision making'. Additionally, publications reporting DA development and actual DAs that were reported as publicly available on the Internet were consulted.

Bowel cancer screening in England: a qualitative study of GPs' attitudes and information needs.

Background: The National Health Service Bowel Cancer Screening Programme is to be introduced in England during 2006. General Practitioners are a potentially important point of contact for participants throughout the screening process. The aims of the study were to examine GPs' attitudes and information needs with regard to bowel cancer screening, with a view to developing an information pack for primary care teams that will be circulated prior to the introduction of the programme.

Women's knowledge about breast cancer risk and their views of the purpose and implications of breast screening--a questionnaire survey.

Objectives: To assess women's knowledge and perception of breast screening, including its benefits and disadvantages, and explore whether demographic and other personal characteristics are associated with accurate knowledge.

Design: Questionnaire survey of a random sample of 1000 women aged between 49 and 64 years registered with GPs in Oxfordshire.

Results: Thirty-six per cent of women knew the lifetime risk of developing breast cancer, and the interpretation of numeric risks varied among women.

Informed decision making and prostate specific antigen (PSA) testing for prostate cancer: a randomised controlled trial exploring the impact of a brief patient decision aid on men's knowledge, attitudes and intention to be tested.

Objective: To examine the impact of a brief patient decision aid (pDA) on men's knowledge, attitudes and intention to have a prostate specific antigen (PSA) test. To explore the important predictors of intention to be tested in men who received the brief pDA.

Methods: A brief pDA designed to facilitate informed decision-making for men considering PSA testing was developed for the NHS Prostate Cancer Risk Management Programme.

Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations.

A man's decision to have a prostate-specific antigen (PSA) test should be an informed one. We undertook a systematic review to identify and appraise PSA decision aids and evaluations. We searched 15 electronic databases and hand-searched key journals.