Non- or full-laxative CT colonography vs. endoscopic tests for colorectal cancer screening: A randomised survey comparing public perceptions and intentions to undergo testing

摘要

Objectives: Compare public perceptions and intentions to undergo colorectal cancer screening tests following detailed information regarding CT colonography (CTC; after non-laxative preparation or full-laxative preparation), optical colonoscopy (OC) or flexible sigmoidoscopy (FS). Methods: A total of 3,100 invitees approaching screening age (45-54 years) were randomly allocated to receive detailed information on a single test and asked to return a questionnaire. Outcomes included perceptions of preparation and test tolerability, health benefits, sensitivity and specificity, and intention to undergo the test. Results: Six hundred three invitees responded with valid questionnaire data. Non-laxative preparation was rated more positively than enema or full-laxative preparations [effect size (r)=0.13 to 0.54; p<0.0005 to 0.036]; both forms of CTC and FS were rated more positively than OC in terms of test experience (r=0.26 to 0.28; all p-values<0.0005). Perceptions of health benefits, sensitivity and specificity (p=0.250 to 0.901), and intention to undergo the test (p=0.213) did not differ between tests (n=144-155 for each test). Conclusions: Despite non-laxative CTC being rated more favourably, this study did not find evidence that offering it would lead to substantially higher uptake than full-laxative CTC or other methods. However, this study was limited by a lower than anticipated response rate. Key Points: ? Improving uptake of colorectal cancer screening tests could improve health benefits ? Potential invitees rate CTC and flexible sigmoidoscopy more positively than colonoscopy ? Non-laxative bowel preparation is rated better than enema or full-laxative preparations ? These positive perceptions alone may not be sufficient to improve uptake ? Health benefits and accuracy are rated similarly for preventative screening tests