Measuring patient-centered communication in colorectal cancer care

Every year, 340,000 Americans are diagnosed with cancer, and fully 4 in 10 of these diagnoses will be colorectal cancer (CRC). CRC is the second leading cause of cancer death in the United States; however, 60% of CRC deaths could be prevented if everyone 50 years old and older were screened.

By instituting patient-centered communication, we can increase screenings.

What is patient-centered communication, and how can we assess it?

Patient-centered communication considers the patient’s needs and values, involves the patient in care decisions, and builds stronger patient-provider relationships. This communication style has been linked to greater patient satisfaction, treatment adherence, and quality of life, and has the potential to help patients:

  • Handle the emotional impact of a diagnosis
  • Make sense of complex medical information
  • Manage side effects and symptoms
  • Make informed decisions about their care
  • Deal with uncertainties
  • Adopt health-promoting behaviors

RTI International, along with partners from the University of North Carolina at Chapel Hill and Fight Colorectal Cancer, recently developed a publicly available, easy-to-use survey instrument [PDF] for measuring patient-centered communication in cancer care (PCC-Ca). The PCC-Ca instrument is available as both a 36- and 6-item questionnaire and can be self-administered using a paper- or web-based survey. The instrument was validated with a CRC patient population, but was designed for use with other cancer types as well.

Epstein RM, Street RL Jr. Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering. Bethesda, MD: National Cancer Institute; 2007. NIH Publication No. 07-6225.

Epstein RM, Street RL Jr. Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering. Bethesda, MD: National Cancer Institute; 2007. NIH Publication No. 07-6225.

When is patient-centered communication important?

High quality patient-provider communication is critical at all stages along the cancer care continuum, from screening through treatment and end of life. At all phases, providers may have to assess and help patients manage symptoms, foster change in health behaviors, help patients understand and deal with uncertainty, and discuss plans for the future.

A study published in Medical Care, Influence of Patient-Provider Communication on Colorectal Cancer Screening, highlighted the importance of patient-provider communication at the screening phase. The study found that communication was a leading factor in choosing to be screened. Patients who felt they had sufficient time with their healthcare provider were more likely to be screened for CRC. The study also determined that those who received an adequate explanation of healthcare needs were more likely to agree to a fecal occult blood test, which screens for early colon cancer.

Check out the PCC-Ca User Guide to learn more and access the instrument.

Bryce Reeve

Bryce Reeve

Professor at University of North Carolina at Chapel Hill
Dr. Bryce Reeve is a Professor within the Gillings School of Global Public Health and member of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill. Dr. Reeve’s work focuses on enhancing the application of patient-reported data in clinical research and practice to improve the quality of care for pediatric and adult cancer patients. This includes the development of patient-reported questionnaires using qualitative and quantitative methodologies and integration of patient-reported data in research and healthcare delivery to inform decision-making.
Bryce Reeve

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Katherine Treiman

Katherine Treiman

Senior Manager, Public Health at RTI International
Katherine A. Treiman, PhD, MPH is a senior research scientist in RTI International’s Center for Communication Science, Patient and Family Engagement Research Program. She is interested in patient-centered care and communication, particularly in the context of cancer care. She has evaluated programs and conducted surveys of cancer patients as part of studies funded by the National Cancer Institute, the American Cancer Society, and the LIVESTRONG Foundation. Currently she is working with a private foundation to develop a patient-centered cancer care initiative.
Katherine Treiman

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Lauren McCormack

Lauren McCormack

Vice President, Public Health Research Division at RTI International
Lauren McCormack, PhD, MSPH is Vice President of the Public Health Research Division of RTI International and Adjunct Associate Professor at the University of North Carolina's School of Public Health. Dr McCormack's research bridges the fields of public health and communication science. Her work focuses on promoting informed decision making, public engagement, and behavior change. An overarching goal of her research is to improve the public’s understanding and use of scientific evidence in decision making. She is an internationally recognized expert in health literacy and serves as Chair of PCORI’s Advisory Panel on Communication & Dissemination.
Lauren McCormack
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About Lauren McCormack, Katherine Treiman, and Bryce Reeve

Dr. Bryce Reeve is a Professor within the Gillings School of Global Public Health and member of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill. Dr. Reeve’s work focuses on enhancing the application of patient-reported data in clinical research and practice to improve the quality of care for pediatric and adult cancer patients. This includes the development of patient-reported questionnaires using qualitative and quantitative methodologies and integration of patient-reported data in research and healthcare delivery to inform decision-making.