Table 2 Checklist of topics to be discussed during initial counseling for cancer screening
Step 1: Counseling awareness of susceptibility and seriousness (C1) | ||
|---|---|---|
S1a | Have you ever heard of cancer and how harmful is it? | |
□ | □ | It damages the organ it originates first. |
□ | □ | It then metastases and invades various organs like the lung, brain, liver, bone etc. |
□ | □ | It can cause various physical sufferings like pain, dysfunction, wasting syndrome etc. |
□ | □ | It can cause various psychological sufferings like fears, anxiety, depression etc. |
□ | □ | There are no-radical cures for most cancers and the disease has a high mortality. |
□ | □ | Most cancer therapies are costly and have side effects. |
□ | □ | It affects one’s work, study and business pursues. |
□ | □ | It incurs economic burdens and psychological sufferings on family members and the beloved. |
□ | □ | It may damage family relations. |
□ | □ | It damages one’s image among and expectations by others. |
□ | □ | Other (please enter) |
S1b | How, do you think, are the chances for a general farmer in China to get cancer? | |
□ | □ | It’s easy to name friends/acquaintances diagnosed with cancer |
□ | □ | Everyone is susceptible to cancer |
□ | □ | Each year, 300 out of 100 thousand farmers get cancer |
□ | □ | One’s life time chances for getting cancer estimates over 21 % |
□ | □ | Other (please enter) |
S1c | How do you think of your own chances to get cancer? | |
□ | □ | I/You have elevated chances for getting [gastric] cancer. |
□ | □ | My/Your latest cancer risk score is [92] |
□ | □ | It ranks top 6 % among all farmers age 35 years and older. |
□ | □ | [I/You have an elder brother who had diagnosed with gastric cancer]. |
□ | □ | [I/You have been suffering from chronic gastritis for 27 years]. |
□ | □ | [I/You have been eating cured meat and vegetables most frequently for 55 years]. |
□ | □ | [I/You have been a heavy alcohol drinker for 40 years]. |
□ | □ | [I/You have been smoking about 30 cigarettes a day for 45 years]. |
□ | □ | [I/You have been suffering from chronic gastritis for over 20 years]. |
□ | □ | [I/You have been feeling decreasing appetite for the last 3 years]. |
□ | □ | Other (please enter) |
Step 2: Counseling beliefs in effectiveness and benefits of CS (C2) | ||
S2a | What, do you think, you can get from cancer screening? | |
□ | □ | Most cancers develop through a long-period of pre-cancerous conditions [like polyps, atrophic gastritis]. |
□ | □ | These pre-cancerous conditions can be corrected at a minimum cost. |
□ | □ | Cancer screening can detect and correct the pre-cancerous conditions and thus prevent cancers. |
□ | □ | After onset, cancer proliferates and damages human body at an escalating speed. |
□ | □ | At early stages, cancer cells confine within limited boundary and can be radically cleared, e.g., by surgery. |
□ | □ | At late stages, cancer cells metastases to other organs and becomes hard to be cleared from human body. |
□ | □ | When specific symptoms are felt, cancer has generally developed into quite late a stage. |
□ | □ | The earlier the detection of cancer, the better the outcomes of cancer treatment. |
□ | □ | Regular screening not only detects early cancer but also communicates knowledge about cancer. |
□ | □ | Cancer screening also helps in finding and correcting other health problems. |
□ | □ | Other (please enter) |
Step 3: Counseling anticipation of barriers and problems (C3) | ||
S3a | What problems or barriers you may encounter in seeking cancer screening? | |
□ | □ | I/You feel it ominous seeking cancer screening. |
□ | □ | I/You fear that cancer screening may damage my health and cost me too much. |
□ | □ | I/You don’t want to upset/scare my family by telling them that I need cancer screening |
□ | □ | I/You do not know where to get cancer screening. |
□ | □ | I/You don’t know when to seek cancer screening. |
□ | □ | I/You fear that cancer screening may take too long time and I have a tight time table. |
□ | □ | I/You don’t know how to prepare for cancer screening. |
□ | □ | It makes me and my family members worry too much if I were diagnosed with cancer. |
□ | □ | I/You may be stigmatized if I were diagnosed with cancer. |
□ | □ | Other (please enter) |
Step 4: Counseling resource use and skills improvement (C4) | ||
S4a | Now, let’s discuss how to overcome these problems or barriers? | |
□ | □ | [Many researches have proved that cancer screening greatly reduces cancer risks and harms.] |
□ | □ | [Many of your peers, e.g., …, have been receiving regular screening and keep free from cancer for years.] |
□ | □ | [Cancer screening does not harm to your health except minimum pain and uncomfortable experiences.] |
□ | □ | [It costs a few hundred yuan depending only type and content of examinations/tests to be performed.] |
□ | □ | [Most cancer screening expenditures can be claimed back from national insurance programs.] |
□ | □ | [Talking about cancer screening with your family member(s) does much more benefits than harms.] |
□ | □ | [It gains you various supports to implement cancer screening as well as other protective behaviors.] |
□ | □ | [It also conveys useful information about cancer screening and prevention to your family member(s).] |
□ | □ | [You can get cancer screening from any cancer specialty or general hospital of county level or over.] |
□ | □ | [Here is a list of qualified hospitals that provides cancer screening and their contact details.] |
□ | □ | [Here is a referral letter that tells why you need screening and what type of screening suits you most.] |
□ | □ | [You need to get your first cancer screening as soon as possible.] |
□ | □ | [Then you need to seek cancer screening every few years depending on results of the previous screening.] |
□ | □ | [Cancer screening takes no longer than a half day and there are always ways to arrange such a time.] |
□ | □ | [Medical checkup is always a justified reason asking for favor from relatives, friends, managers etc.] |
□ | □ | [If in need, I would like to write you a letter as a proof for asking for such helps.] |
□ | □ | [You needn’t any preparation except that you do not eat and drink 6 h before cancer screening.] |
□ | □ | [You’d better ask accompany from a close relative or friend, which gives various supports and helps.] |
□ | □ | [Negative screening result frees you and your relatives from worries rather than aggravates worries.] |
□ | □ | [Even for those screened with positive results, they perceive the screening as a right rather than regretful decision, since it entails earlier treatment and better prognosis.] |
□ | □ | [Doctors have obligations not to tell your diagnose to anyone else without your permission.] |
□ | □ | [You may choose to disclose your diagnose to those you trust most or only yourself.] |
□ | □ | Other (please enter) |