In the British Medical Journal this week, researchers at the University of Hamburg in Germany present findings from a randomized control trial of the effects of presenting evidence-based risk information to patients as they make choices on colorectal cancer screening methods. The researchers tested 1,577 people with no history of colorectal cancer, and split them into two group — one receiving a brochure with evidence-based risk information on the screening methods, and the other receiving the official information leaflet on colorectal cancer screening from the German government as a control. About 44 percent of the people in the experimental group made an "informed choice," compared with 12.8 percent in the control group, however the experimental group had a lower rate of "positive attitude" toward colorectal cancer screening than the control group, the authors write. "Evidence-based risk information on colorectal cancer screening increased informed choices and improved knowledge, with little change in attitudes. The intervention did not affect the combination of actual and planned uptake of screening," they add.
Also in the British Medical Journal this week, Ingrid Torjesen reports that fewer cancer tests and a "rational use of chemotherapy" can help to reduce the costs of treating cancer. US clinicians Thomas Smith and Bruce Hillner recently wrote an editorial in NEJM, saying that the current trend of rising prices for cancer treatments can be curbed in part by clinicians. Last year, Torjesen adds, the director of the Institute for the Medical Humanities at the University of Texas Medical Branch, Howard Brody, said doctors should develop a list of the five most commonly ordered diagnostics and treatments that are expensive and haven't been shown to be very beneficial. Smith and Hillner responded, saying that regularly scheduled surveillance testing with serum tumor markers or imaging for most cancers should be avoided unless there are new symptoms, Torjesen writes. They also suggested that cancer drugs should be given sequentially and not in combination.