Selective information seeking: can consumers' avoidance of evidence-based information on colorectal cancer screening be explained by the theory of cognitive dissonance?

Background: Evidence-based patient information (EBPI) is a prerequisite for informed decision-making. However, presentation of EBPI may lead to irrational reactions causing avoidance, minimisation and devaluation of the information. Objective: To explore whether the theory of cognitive dissonance is applicable to medical decision-making and useful to explain these phenomena. Setting and participants: 261 volunteers from Hamburg (157 women), ≥50 years old without diagnosis of colorectal cancer. Design and variables: Within an experiment we simulated information seeking on colorectal cancer screening. Consumers’ attitudes towards screening were surveyed using a rating scale from -5 (participate in no way) to +5 (participate unconditionally) (independent variable). Using a cover story, participants were asked to sort 5 article headlines according to their reading preferences. The headlines simulated the pro to contra variety of contents to be found in print media about colorectal cancer screening. The dependent variable was the sequence of article headlines. Results: Participants were very much in favour of screening with scores for faecal occult blood test of 4.0 (0.1) and for colonoscopy 3.3 (0.1). According to our hypothesis we found statistically significant positive correlations between the stimuli in favour of screening and attitudes and significant negative correlations between the stimuli against screening and attitudes. Conclusion: The theory of cognitive dissonance is applicable to medical decision-making. It may explain some phenomena of irrational reactions to evidence-based patient information.