Patient experience of CT colonography and colonoscopy after fecal occult blood test in a national screening programme

Objective

To investigate patient experience of CT colonography (CTC) and colonoscopy in a national screening programme.

Methods

Retrospective analysis of patient experience postal questionnaires. We included screenees from a fecal occult blood test (FOBt) based screening programme, where CTC was performed when colonoscopy was incomplete or deemed unsuitable. We analyzed questionnaire responses concerning communication of test risks, test-related discomfort and post-test pain, as well as complications. CTC and colonoscopy responses were compared using multilevel logistic regression.

Results

Of 67,114 subjects identified, 52,805 (79 %) responded. Understanding of test risks was lower for CTC (1712/1970?=?86.9 %) than colonoscopy (48783/50975?=?95.7 %, p?p?p?p?=?0.55). Adverse event rates were similar in both groups (CTC: 20/2947?=?1.2 %; colonoscopy: 683/64,312?=?1.1 %), but generally less serious with CTC.

Conclusions

Even though CTC was reserved for individuals either unsuitable for or unable to complete colonoscopy, we found only small differences in test-related discomfort. CTC was well tolerated as a completion procedure and was extremely safe. CTC can be delivered across a national screening programme with high patient satisfaction.

Key Points

? High patient satisfaction at CTC is deliverable across a national screening programme. ? Patients who cannot tolerate screening colonoscopy are likely to find CTC acceptable. ? CTC is extremely safe; complications are rare and almost never serious. ? Patients may require more detailed information regarding the expected discomfort of CTC.