Using a hypothetical scenario to assess public preferences for colorectal surveillance following screening-detected, intermediate-risk adenomas: annual home-based stool test vs. triennial colonoscopy

Bernardette Bonello, Alex Ghanouni, Harriet L Bowyer, Eilidh MacRae, Wendy Atkin, Stephen P Halloran, Jane Wardle, Christian von Wagner, Bernardette Bonello, Alex Ghanouni, Harriet L Bowyer, Eilidh MacRae, Wendy Atkin, Stephen P Halloran, Jane Wardle, Christian von Wagner

Abstract

Background: To assess public preferences for colorectal cancer (CRC) surveillance tests for intermediate-risk adenomas, using a hypothetical scenario.

Methods: Adults aged 45-54 years without CRC were identified from three General Practices in England (two in Cumbria, one in London). A postal survey was carried out during a separate study on preferences for different first-line CRC screening modalities (non- or full-laxative computed tomographic colonography, flexible sigmoidoscopy, or colonoscopy). Individuals were allocated at random to receive a pack containing information on one first-line test, and a paragraph describing CRC surveillance recommendations for people who are diagnosed with intermediate-risk adenomas during screening. All participants received a description of two surveillance options: annual single-sample, home-based stool testing (consistent with Faecal Immunochemical Tests; FIT) or triennial colonoscopy. Invitees were asked to imagine they had been diagnosed with intermediate-risk adenomas, and then complete a questionnaire on their surveillance preferences.

Results: 22.1 % (686/3,100) questionnaires were returned. 491 (15.8 %) were eligible for analysis. The majority of participants stated a surveillance preference for the stool test over colonoscopy (60.8 % vs 31.0 %; no preference: 8.1 %; no surveillance: 0.2 %). Women were more likely to prefer the stool test than men (66.7 % vs. 53.6 %; p = .011). The primary reason for preferring the stool test was that it would be done more frequently. The main reason to prefer colonoscopy was its superiority at finding polyps.

Conclusions: A majority of participants stated a preference for a surveillance test resembling FIT over colonoscopy. Future research should test whether this translates to greater adherence in a real surveillance setting.

Trial registration: International Standard Randomised Controlled Trial Number registry, ISRCTN85697880 , prospectively registered on 25/04/2013.

Keywords: Cancer surveillance; Colonoscopy; Colorectal cancer; Faecal immunochemical test; Intermediate-risk adenomas; Patient preference.

References

    1. Atkin WS, Saunders BP. Surveillance guidelines after removal of colorectal adenomatous polyps. Gut. 2002;51:v6–9. doi: 10.1136/gut.51.suppl_5.v6.
    1. Winawer S, Zauber A, O’Brien M, Ho M, Gottlieb L, Sternberg S. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. New Engl J Med. 1993;328:901–6. doi: 10.1056/NEJM199304013281301.
    1. Van Stolk R, Beck G, Baron J, Haile R, Summers R. Adenoma characteristics at first colonoscopy as predictors of adenoma recurrence and characteristics at follow-up. Gastroenterology. 1998;115:13–8. doi: 10.1016/S0016-5085(98)70359-2.
    1. Lund JN, Scholefield JH, Grainge MJ, et al. Risks, costs, and compliance limit colorectal adenoma surveillance: lessons from a randomised trial. Gut. 2001;49(1):91–6. doi: 10.1136/gut.49.1.91.
    1. McLachlan S-A, Clements A, Austoker J. Patients’ experiences and reported barriers to colonoscopy in the screening context—A systematic review of the literature. Patient Educ Couns. 2012;86(2):137–46. doi: 10.1016/j.pec.2011.04.010.
    1. Ely JW, Levy BT, Daly J, Xu Y. Patient Beliefs About Colon Cancer Screening. J Cancer Education. Epub ahead of print 27 January 2015; doi: 10.1007/s13187-015-0792-5.
    1. de Wijkerslooth TR, de Haan MC, Stoop EM, et al. Reasons for participation and nonparticipation in colorectal cancer screening: a randomized trial of colonoscopy and CT colonography. Am J Gastroenterol. 2012;107(12):1777–83. doi: 10.1038/ajg.2012.140.
    1. National Institute for Health Research. HTA - 09/22/192: Faecal immunochemical testing (FIT) for adenoma surveillance. FIT for Follow-up. 2011. . Accessed 09 Sept 2015.
    1. Lane JM, Chow E, Young GP, et al. Interval fecal immunochemical testing in a colonoscopic surveillance program speeds detection of colorectal neoplasia. Gastroenterology. 2010;139:1918–26. doi: 10.1053/j.gastro.2010.08.005.
    1. Steele RJC, McDonald P, Digby J, et al. Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity. United European Gastroenterology. 2013;1(3):198–205. doi: 10.1177/2050640613489281.
    1. Xu Y, Levy BT, Daly JM, Bergus GR, Dunkelberg JC. Comparison of patient preferences for fecal immunochemical test or colonoscopy using the analytic hierarchy process. BMC Health Serv Res. 2015;15(1):175. doi: 10.1186/s12913-015-0841-0.
    1. Wilschut JA, Habbema JD, van Leerdam ME, et al. Fecal occult blood testing when colonoscopy capacity is limited. J Natl Cancer Inst. 2011;103(23):1741–51. doi: 10.1093/jnci/djr385.
    1. Hawley ST, McQueen A, Bartholomew LK, et al. Preferences for colorectal cancer screening tests and screening test use in a large multispecialty primary care practice. Cancer. 2012;118(10):2726–34. doi: 10.1002/cncr.26551.
    1. Hol L, de Bekker-Grob EW, van Dam L, et al. Preferences for colorectal cancer screening strategies: a discrete choice experiment. Br J Cancer. 2010;102(6):972–80. doi: 10.1038/sj.bjc.6605566.
    1. Lv D, Hol L, Bekker-Grob EW. What determines individuals’ preferences for colorectal cancer screening programmes? A discrete choice experiment. Eur J Cancer. 2010;46(1):150–9. doi: 10.1016/j.ejca.2009.07.014.
    1. Marshall DA, Johnson FR, Phillips KA, Marshall JK, Thabane L, Kulin NA. Measuring patient preferences for colorectal cancer screening using a choice-format survey. Value Health. 2007;10(5):415–30. doi: 10.1111/j.1524-4733.2007.00196.x.
    1. Wolf RL, Basch CE, Brouse CH, Shmukler C, Shea S. Patient preferences and adherence to colorectal cancer screening in an urban population. Am J Public Health. 2006;96(5):809–11. doi: 10.2105/AJPH.2004.049684.
    1. Bowyer HL, Vart G, Kralj-Hans I, et al. Patient attitudes towards faecal immunochemical testing for haemoglobin as an alternative to colonoscopic surveillance of groups at increased risk of colorectal cancer. J Med Screen. 2013;20(3):149–56. doi: 10.1177/0969141313503953.
    1. Droste JS T s, van Turenhout ST, Oort FA, et al. Faecal immunochemical test accuracy in patients referred for surveillance colonoscopy: a multi-centre cohort study. BMC Gastroenterol. 2012;24:12–94.
    1. de Wijkerslooth TR, Stoop EM, Bossuyt PM, et al. Immunochemical fecal occult blood testing is equally sensitive for proximal and distal advanced neoplasia. Am J Gastroenterol. 2012;107(10):1570–8. doi: 10.1038/ajg.2012.249.
    1. Quintero E, Carrillo M, Gimeno-García AZ, et al. Equivalency of Fecal Immunochemical Tests and Colonoscopy in Familial Colorectal Cancer Screening. Gastroenterology. 2014;147(5):1021–30.e1. doi: 10.1053/j.gastro.2014.08.004.
    1. Ghanouni A, Halligan S, Plumb A, Boone D, Wardle J, von Wagner C. Non- or full-laxative CT colonography vs. endoscopic tests for colorectal cancer screening: A randomised survey comparing public perceptions and intentions to undergo testing. Eur Radiol. 2014;24(7):1477–86. doi: 10.1007/s00330-014-3187-9.
    1. Department for Communities and Local Government. The English indices of deprivation 2010. 2011. . Accessed 8 Apr 2015.
    1. Segnan N, Senore C, Andreoni B, et al. Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. Gastroenterology. 2007;132(7):2304–12. doi: 10.1053/j.gastro.2007.03.030.
    1. Denberg TD, Melhado TV, Coombes JM, et al. Predictors of nonadherence to screening colonoscopy. J Gen Intern Med. 2005;20(11):989–95. doi: 10.1111/j.1525-1497.2005.00164.x.
    1. Wong RK, Wong ML, Chan YH, Feng Z, Wai CT, Yeoh KG. Gender differences in predictors of colorectal cancer screening uptake: a national cross sectional study based on the health belief model. BMC Public Health. 2013;13:677–77. doi: 10.1186/1471-2458-13-677.
    1. Ussui VS, Silva ALW, Borges LV, Silva JGN, Zeitune JMR, Hashimoti CL. What are the most important factors regarding acceptance to the colonoscopy?: Study of related tolerance parameters. Arq Gastroenterol. 2013;50:23–30. doi: 10.1590/S0004-28032013000100006.
    1. Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP. Patient pain during colonoscopy: An analysis using real-time magnetic endoscope imaging. Endoscopy. 2002;34(06):435–40. doi: 10.1055/s-2002-31995.
    1. Park DI, Kim HJ, Park JH, et al. Factors affecting abdominal pain during colonoscopy. Eur J Gastroenterol Hepatol. 2007;19(8):695–9. doi: 10.1097/01.meg.0000219097.32811.24.
    1. Clarke N, Sharp L, Osborne A, Kearney PM. Comparison of Uptake of Colorectal Cancer Screening Based on Fecal Immunochemical Testing (FIT) in Males and Females: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev. 2015;24(1):39–47. doi: 10.1158/1055-9965.EPI-14-0774.
    1. de Wijkerslooth TR, de Haan MC, Stoop EM, et al. Burden of colonoscopy compared to non-cathartic CT-colonography in a colorectal cancer screening programme: randomised controlled trial. Gut. 2012;61(11):1552–9. doi: 10.1136/gutjnl-2011-301308.
    1. Stegeman I, van Doorn SC, Mundt MW, et al. Participation, yield, and interval carcinomas in three rounds of biennial FIT-based colorectal cancer screening. Cancer Epidemiol. 2015;39:388–93. doi: 10.1016/j.canep.2015.03.012.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться