Limitations
cancer
CANCER
This study has several limitations. First, the study was powered for the primary outcome of decisional conflict at 1 month after intervention, and other findings are considered exploratory. Further, decisional conflict scores were relatively low in both groups, limiting the ability to detect clinically significant differences. Second, study participants were limited to US veterans receiving primary care in a VA Medical Center, a population that is primarily male and specific to the US, limiting generalizability. However, participants were diverse in many respects, including race, educational background, and health numeracy. Third, individuals willing to participate in a clinical trial about cancer screening may be more health conscious and inclined to participate in cancer screening, leading to selection bias. Finally, the study period included the COVID-19 pandemic. Protocol adaptations such as inclusion of remote study and clinic visits were required.