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Colorectal Cancer Screening During the COVID-19 Pandemic

Shared decision-making (SDM) can help patients make good decisions about preventive health interventions such as cancer screening. We illustrate the use of SDM in the case of a 53-year-old man who had a new patient visit with a primary care physician and had never been screened for colorectal cancer...

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Autores principales: Simmons, Leigh H., Frosch, Dominick L., Schapira, Marilyn M., Barry, Michael J., Sepucha, Karen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360678/
https://www.ncbi.nlm.nih.gov/pubmed/35941493
http://dx.doi.org/10.1007/s11606-022-07642-x
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author Simmons, Leigh H.
Frosch, Dominick L.
Schapira, Marilyn M.
Barry, Michael J.
Sepucha, Karen
author_facet Simmons, Leigh H.
Frosch, Dominick L.
Schapira, Marilyn M.
Barry, Michael J.
Sepucha, Karen
author_sort Simmons, Leigh H.
collection PubMed
description Shared decision-making (SDM) can help patients make good decisions about preventive health interventions such as cancer screening. We illustrate the use of SDM in the case of a 53-year-old man who had a new patient visit with a primary care physician and had never been screened for colorectal cancer (CRC). The patient had recently recovered from a serious COVID-19 infection requiring weeks of mechanical ventilation. When the primary care physician initially offered a screening colonoscopy, the man expressed great reluctance to return to the hospital for the exam. The PCP then offered a stool test, which could be completed at home, but emphasized that if it were positive, a colonoscopy would be required. He agreed to complete the stool test, and unfortunately, it was positive. He then agreed to undergo colonoscopy, which uncovered a large rectal cancer. The carcinoma had invaded the mesorectal fat but there were no metastases. After undergoing neoadjuvant chemotherapy followed by a low anterior resection of the tumor, he has no evidence of recurrence so far. Many clinicians favor colonoscopy for CRC screening, but evidence suggests that patients who are offered more than one reasonable option are more likely to undergo screening. If screening had been delayed in this patient until he was willing to accept a screening colonoscopy, there was the potential the cancer may have been more advanced when diagnosed, with a worse outcome. Shared decision-making was a key approach to understanding the patient’s feelings related to this screening decision and making a decision consistent with his preferences.
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spelling pubmed-93606782022-08-09 Colorectal Cancer Screening During the COVID-19 Pandemic Simmons, Leigh H. Frosch, Dominick L. Schapira, Marilyn M. Barry, Michael J. Sepucha, Karen J Gen Intern Med Original Article Shared decision-making (SDM) can help patients make good decisions about preventive health interventions such as cancer screening. We illustrate the use of SDM in the case of a 53-year-old man who had a new patient visit with a primary care physician and had never been screened for colorectal cancer (CRC). The patient had recently recovered from a serious COVID-19 infection requiring weeks of mechanical ventilation. When the primary care physician initially offered a screening colonoscopy, the man expressed great reluctance to return to the hospital for the exam. The PCP then offered a stool test, which could be completed at home, but emphasized that if it were positive, a colonoscopy would be required. He agreed to complete the stool test, and unfortunately, it was positive. He then agreed to undergo colonoscopy, which uncovered a large rectal cancer. The carcinoma had invaded the mesorectal fat but there were no metastases. After undergoing neoadjuvant chemotherapy followed by a low anterior resection of the tumor, he has no evidence of recurrence so far. Many clinicians favor colonoscopy for CRC screening, but evidence suggests that patients who are offered more than one reasonable option are more likely to undergo screening. If screening had been delayed in this patient until he was willing to accept a screening colonoscopy, there was the potential the cancer may have been more advanced when diagnosed, with a worse outcome. Shared decision-making was a key approach to understanding the patient’s feelings related to this screening decision and making a decision consistent with his preferences. Springer International Publishing 2022-08-08 2022-10 /pmc/articles/PMC9360678/ /pubmed/35941493 http://dx.doi.org/10.1007/s11606-022-07642-x Text en © The Author(s), under exclusive licence to Society of General Internal Medicine 2022
spellingShingle Original Article
Simmons, Leigh H.
Frosch, Dominick L.
Schapira, Marilyn M.
Barry, Michael J.
Sepucha, Karen
Colorectal Cancer Screening During the COVID-19 Pandemic
title Colorectal Cancer Screening During the COVID-19 Pandemic
title_full Colorectal Cancer Screening During the COVID-19 Pandemic
title_fullStr Colorectal Cancer Screening During the COVID-19 Pandemic
title_full_unstemmed Colorectal Cancer Screening During the COVID-19 Pandemic
title_short Colorectal Cancer Screening During the COVID-19 Pandemic
title_sort colorectal cancer screening during the covid-19 pandemic
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360678/
https://www.ncbi.nlm.nih.gov/pubmed/35941493
http://dx.doi.org/10.1007/s11606-022-07642-x
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