Assessing the quality of cancer screening leaflets using the International Patient Decision Aids Standards instrument: A cross-sectional content analysis

Abstract

Objective: To assess the quality of national cancer screening program leaflets in Japan from the informed-decision perspective.

Methods: Cross-sectional content analysis of invitation leaflets issued by centralized organizations and used nationwide in Japan was conducted. Three members independently evaluated the materials using International Patient Decision Aids Standards six-item minimum criteria for qualifying patient decision aids.

Patient public involvement: Co-author KH is a cancer patient himself. We also sought feedbacks from three other cancer survivors and two bereaved family members.

Results: Inter-rater agreement was substantial (Fleiss' kappa=0.62). The median score was 2 out of 6 (range: 2-3). All leaflets described the cancer (Q1: 7/7) and screening modality (Q2: 7/7). None stated not undergoing screening as an option. One stated another screening modality (Q3: 1/7). None stated both the positive and negative features of multiple options (Q4: 0/7. Q5: 0/7). One described the psychological and social experience of screening but only its positive side (Q6: 1/7).

Conclusions: There is room for improvement in the content of the public cancer screening invitation leaflets in Japan from informed-decision perspective.

Practice implications: Cancer screening leaflets should provide evidence-based, well-balanced, easy-to-understand information to educate people on cancer screening while maintaining people's autonomy.

Keywords: Autonomy; Health promotion; Informed consent; Patient and public involvement; Risk communication; Shared decision making.