Evidence Summary

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Decision aids improve knowledge in people making decisions about cancer screening or early cancer treatment

Trikalinos TA, Wieland LS, Adam GP, et al. Decision Aids for Cancer Screening and Treatment AHRQ Comparative Effectiveness Reviews. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Dec. Report No: 15-EHC002-EF.

Review question

Do decision aids help people make decisions about cancer screening, cancer prevention, or treatment for early cancer?


There are often both harms and benefits to consider when making decisions about screening for cancer and treatment for cancer. Decision aids provide information to help people take an active role in making informed decisions about their health care options with the help of their health care providers. They can help by increasing people’s knowledge of what’s involved, what’s at stake, and what options are available. Thus, decision aids make people feel more informed when making health care decisions.

How the review was done

The researchers did a systematic review, searching for published studies of decision aids up to June 2014. They found 68 randomized controlled trials of 25,337 people.

In the trials, people were making decisions about screening or early cancer treatment for breast, prostate, colon, ovarian, cervical, or thyroid cancer. Decision aids were provided at the time of the actual decision.

Types of decision aids included audio and visual media, software or websites, printed materials, option grids, and in-person education.

What the researchers found

Compared with not using decision aids, the use of decision aids:

  • increased people’s knowledge about the different options;
  • slightly reduced decisional conflict (feeling uninformed); and
  • did not affect anxiety.


In people who have to make a decision about screening for cancer or early treatment for cancer, decision aids increase knowledge about the different options and reduce the number of people who feel uninformed or unclear about their options. Use of decision aids did not affect anxiety.

Use of decision aids vs not using decision aids for making decisions about screening for cancer or early treatment for cancer


Number of trials (number of people)

Effect of using decision aids vs no decision aids

Quality of evidence


38 trials (12,484 people)

Knowledge increased


Decisional conflict (feeling uninformed)

28 trials (7923 people)

People felt slightly more informed ( about 2 to 10 points out of 100)



12 trials (2958 people)

Anxiety did not differ between groups




Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

  • Breast cancer: Risks and benefits, age 50-69

    Canadian Task Force on Preventive Health Care
    Your risk of dying from breast cancer is slightly reduced if you have regular screening. However, regular screening increases your chance of a false positive result, a biopsy and having part or all of a breast removed unnecessarily.
  • Breast cancer: Patient algorithm

    Canadian Task Force on Preventive Health Care
    The Canadian Task Force on Preventive Health Care recommends women between 50 and 74 years old who are not at high risk get screened for breast cancer every 2 to 3 years. Talk to your doctor about screening options if you are at high risk or over 74 years old.
  • Breast cancer: Patient FAQ

    Canadian Task Force on Preventive Health Care
    This resource includes frequently asked questions about breast cancer, including: Who is considered high risk? What are the harms associated with mammography? and Why is routine screening NOT recommended for women 40-49 years?
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