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Shared decision making and patient satisfaction in colorectal cancer screening: a multicentric cross-sectional study
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DOI：10.1186/s12885-026-16711-x.png)
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Abstract
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Colorectal cancer (CRC) screening programs reduce incidence and mortality, but their success depends not only on clinical effectiveness but also on participants’ experience and satisfaction. Understanding these dimensions is crucial, as poor satisfaction or limited involvement in shared decision-making (SDM) can undermine uptake and adherence. This study evaluated SDM and satisfaction among participants with a positive fecal immunochemical test (FIT) in an organized CRC screening program in Catalonia. A multicenter cross-sectional study was conducted from November 2020 to December 2021 across three hospitals. Participants aged 50–69 with a positive FIT result were surveyed after colonoscopy and diagnosis. SDM was measured using CollaboRATE and SDM-Q-9; satisfaction was assessed using Hatoum’s and Colonoscopy Safety and Satisfaction Questionnaire questionnaires and custom tools. Multivariate analyses identified factors associated with SDM and satisfaction. Of 846 invited, 824 were included and 694 completed questionnaires (84.2% response rate). Overall, 39.8% achieved the CollaboRATE top score. Higher SDM was linked to shorter wait times, use of Moviprep®,a bowel preparation solution, and absence of complications. Among CRC-diagnosed patients, women and those with a personal cancer history reported higher SDM. Overall satisfaction was high (mean 9.4/10), though bowel preparation scored lowest. Satisfaction varied by hospital, preparation type, and patient characteristics, but not by final diagnosis. Participants reported high satisfaction but moderate SDM, revealing room for improvement. Factors such as preparation type, waiting time, and communication quality shaped patient experience. Differences across centers suggest organizational factors matter. Strengthening communication, reducing delays, and addressing patient diversity are essential to enhance satisfaction and engagement, key drivers of CRC screening program effectiveness.
Keywords:
Patient satisfaction
Mass screening
Early detection of cancer
Colorectal neoplasms
Decision Making
Shared
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