Abstract
Background
Current American Cancer Society recommendations for colon cancer screening include optical colonoscopy every 10 years or computed tomography colonography (CTC) every 5 years. Bowel preparation (BP) is currently required for both screening modalities.
Purpose
To compare ACRIN 6664: the National CT Colonography Trial (NCTCT) participant experiences with CTC and optical colonoscopy (OC), procedure preference, and willingness to return for each procedure.
Materials and methods
Participants from fifteen NCTCT sites, who underwent CTC followed by OC under sedation, were invited to complete questionnaires 2 weeks postexam, asking about procedure preference, physical discomfort, and embarrassment experienced and whether that discomfort and embarrassment was better or worse than expected during BP, CTC, and OC, as well as willingness to return for repeat CTC and OC at different time intervals.
Results
A total of 2,310 of 2,600 patients (89%) returned their questionnaires. Of patients reporting a preference, 1,058 (46.6%) preferred CTC, 569 (25.0%) preferred OC, and 626 (27.6%) reported no preference. Participant-reported discomfort worse than expected differed significantly between CTC (32.9%) and OC (5.0%) (P<0.001). About 79.3% were willing to be screened again with CTC in 5 years, and 96.6% with OC in 10 years. Discomfort and embarrassment worse than expected with OC were associated with increased intention to adhere with CTC in the future. Conversely, embarrassment experienced during CTC and discomfort worse than expected on CTC were associated with increased intention to adhere with OC in the future.
Conclusion
While a larger proportion of participants indicated that they preferred CTC to OC, willingness to undergo repeat CTC compared to OC was limited by unanticipated exam discomfort and embarrassment and CTC’s shorter screening interval.
Supplementary material
Permission to conduct the study was obtained from the institutional review boards of: Brown University, Providence, RI; Mayo Clinic, Scottsdale, Scottsdale, AZ; Scottsdale Medical Imaging, Ltd., Scottsdale, AZ; UCLA School of Medicine, Los Angeles, CA; UCSD Medical Center, San Diego, CA; San Francisco VA Medical Center (SFVAMC), San Francisco, CA; Radiology Imaging Associates, Englewood, CO; Yale University, New Haven, CT; University of Chicago Hospital, Chicago, IL; Clinical Radiologists, S.C. Memorial Medical Center; Springfield, IL; Johns Hopkins, Baltimore, MD; Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN; Washington University Medical School, St Louis, MO; MD Anderson, Houston, TX; and Medical College of Virginia Hospitals, Richmond, VA.
Acknowledgments
The authors thank the Screening Center investigators and staff of ACRIN 6664: the National CT Colonography Trial (NCTCT). Most importantly, we acknowledge the study participants, whose contributions made this study possible. We also acknowledge Maryann Duggan, Cheryl Souza, and Nancy Ciminelli for their diligent work in data collection for this study. This study was supported by the National Cancer Institute grant CA 79778 under a cooperative agreement with the Cancer Imaging Program.
Disclosure
Dr Gareen reports grants from the National Cancer Institute, during the conduct of the study. Dr Siewert and Mr Herman have nothing to disclose. Dr Vanness reports grants from American College of Radiology Imaging Network during the conduct of the study. Dr Gatsonis reports grants from the National Cancer Institute, during the conduct of the study; personal fees and other from Wilex AG, personal fees and other from Endocyte Inc, other from Frontier Science Research Foundation, personal fees from Genentech, personal fees from Biomimetics, outside the submitted work. Dr Johnson reports personal fees from GE Medical, outside the submitted work; in addition, Dr Johnson has a patent CT Colonography issued.