Informed decision-making about health interventions needs access to clear information and can be fostered by communication tools such as decision aids.

According to a recent systematic review on treatment and screening decisions (Stacey D. et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2024 Jan 29;1(1):CD001431. doi: 10.1002/14651858.CD001431.pub6. PMID: 38284415; PMCID: PMC10823577), patient decision aids improve knowledge, accuracy of risk perceptions and decrease decisional conflict related to feeling uninformed, indecision about personal values and proportion of people who were passive in decision-making. The European Commission Initiative on Breast Cancer (ECIBC) Guidelines Development Group (GDG) suggests using a decision aid that explains the benefits and harms of screening over an invitation letter, as conditional recommendation – with low certainty of the evidence. 

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While some studies and guidelines from public entities on communication tools in screening are available, what is less known is their effect in risk-based screening. This review is therefore aimed to assess the effect of risk communication tools (such as decision aids) on informed decision in risk-based screening of breast, colorectal, cervical, lung, prostate and gastric cancer. Informed choice, satisfaction with decision making​, confidence with decision making, shared decision-making​, knowledge and participation in screening are among the outcomes.

​We decided to include systematic reviews at first, and retrieve primary studies if no relevant systematic reviews have been found. A systematic search of the relevant resources was implemented by searching the main literature databases, from 01/01/2010 to 01/08/2025. We found 1.568 resources.

The working group – IMIM-Hospital del Mar Research Institute Barcelona; ISPRO Toscana; IRFMN; National Cancer Institute Ukraine; Latvia University; AUSL Reggio Emilia – made the selection of titles and abstracts. We piloted the selection criteria for consistently among the reviewers. Then, each resource was assessed for selection by two independent reviewers and discordances were discussed. After reaching an agreement on discordant assessments, we finally included 68 systematic reviews by title and abstract. The selection of full texts is ongoing.  

Cinzia Colombo IRFMN

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