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Table 2 Checklist of topics to be discussed during initial counseling for cancer screening

From: Assessment and model guided cancer screening promotion by village doctors in China: a randomized controlled trial protocol

Step 1: Counseling awareness of susceptibility and seriousness (C1)


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)


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)


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)


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)


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)


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)

  1. Note: (1) Items without “[]” apply to all patients; while items within “[]” apply only to the specific patient under concern depending on his/her assessed need; (2) The left column check boxes (“□”) are used for checking ideas voiced by the patient independently; while the right column check boxes are used for checking viewpoints the patient agreed upon after he/she has get hints/advices from his/her counselor doctor