Purpose: We sought to compare, in a randomized trial, two different CRC screening decision aids videos.

Methods:  Adults ages 48-75 not currently up to date with screening were randomized to view one of the two decision aid videos. The first video included five screening options, fecal occult blood test (FOBT), sigmoidoscopy, a combination of FOBT and sigmoidoscopy, colonoscopy, and barium enema.  The second video discussed only the two most frequently used screening options, FOBT and colonoscopy. Participants were recruited using participant registries in a non-clinical setting.  Questionnaires assessing screening interest and knowledge were administered before and after the video.  Patient test choice was elicited first without any associated out of pocket costs (OPC), and then with the following costs: FOBT-$10, sigmoidoscopy-$50, colonoscopy-$200, and barium enema-$50.

Results: 62 adults participated: 25 viewed the five option video, and 37 viewed the two option version. Average viewing time for the 5 test option video was 30 minutes and 15 minutes for the 2 test option version.  Mean age was 54 (range 48-72), 58% were women, 71% were White, 24% African-American, 58% had completed at least a 4-year college degree.  Most (58%) had never discussed screening with their doctor. At baseline, 23% were definitely interested in screening; 20% responded to all knowledge questions correctly.  After viewing a video, 45% (p=<0.0001) were definitely interested in screening and 34% (p=<0.0001) responded to all knowledge questions correctly. 

When comparing participants that viewed the five option video with participants who viewed the two option video, there were no differences in interest (1.8 vs 1.9, t-test p=0.7655) and in post-video knowledge scores (2.12 vs. 2.05, t-test p=0.7517; 36% vs. 32% responding correctly to all questions).

 

Test Type	5 Test Option Video			2 Test Option Video
	Without OPC	With OPC	Without OPC		With OPC
FOBT	21%	17%	32%		54%
Sigmoidoscopy	4%	8%	-		-
FOBT & Sigmoidoscopy	21%	21%	-		-
Colonoscopy	46%	42%	68%		41%
Barium Enema	4%	8%	-		-
No Screening	4%	4%	-		5%

 Conclusions:  The number of screening options available does not appear to affect interest in, or knowledge of, colorectal cancer screening. Test choices differed modestly between the two decision aids, those viewing the two test option video were more sensitive to out-of-pocket costs.