Perception of Colonoscopy Benefits and Patient Knowledge
Perception of Colonoscopy Benefits and Patient Knowledge
Our study aimed to determine, for patients who had undergone recent colonoscopy, associations between specific colonoscopy patient characteristics, exam characteristics and patients' perception of colonoscopy reducing their risk of dying from colorectal cancer. A cross-sectional analysis was conducted using data (2004–2008) from the New Hampshire Colonoscopy Registry, consisting of a Self-report Questionnaire, Colonoscopy Report form, and a Follow-up Questionnaire, which measured agreement responses to the statement, "Having a colonoscopy decreased my chances of dying from colon cancer". Chi-square tests and logistic regression were used to assess differences in patient responses by patient and colonoscopy characteristics. A majority of patients (N = 5,672, 81%) agreed that having a colonoscopy decreased their chances of dying from colon cancer. Patients with a personal history of polyps were more likely to agree that colonoscopy reduced their chances of dying compared to patients without prior polypectomy [OR (95% CI) = 1.34 (1.06, 1.69)] and patients with a family history of colorectal cancer were 33% more likely to agree to the statement than those without a family history [OR (95% CI) = 1.33 (1.12, 1.58)]. Personal history of polyps and family history of colorectal cancer are significant predictors of patients' positive perception of colonoscopy, suggesting that personal experience, rather than the potential preventive effect of colonoscopy itself, may influence the perceived benefit of colonoscopy. Intervention efforts should be made to effectively disseminate knowledge of the preventive benefit of colonoscopy.
Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States, but only half of the appropriate population receives CRC screening. The US Preventive Services Task Force (USPSTF) has given CRC screening a grade of A in terms of evidence to support this type of screening, and recommends fecal occult blood testing, sigmoidoscopy, or colonoscopy among adults beginning at age of 50 (for those at average risk) and continuing until age 75. Screening guidelines have also been published by the American Cancer Society and the Multi-Society Task Force; these outline options for both screening and surveillance. The American Society of Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG) recommend colonoscopy as the optimal method for CRC screening; this is currently the most widely used method.
Colonoscopy is the only screening method able to prevent CRC through polypectomy, or the removal of polyps. Primary care providers (PCPs) are responsible for appropriately screening and educating their patients about CRC, including ensuring patient knowledge of the preventive benefit of colonoscopy. Improved understanding of patients' perceptions, particularly in relationship to motivation to undergo colonoscopy, would be essential to increasing patient compliance with screening.
Studies have investigated the relationships between specific patient characteristics—such as family and health history—and knowledge about screening in general as well as understanding of CRC risk. However, the relationship between individual colonoscopy patients' characteristics, exam characteristics (including polyp findings), and their perception of the benefit of colonoscopy screening is still unclear. Studies addressing patient perceptions are useful in understanding motivation to undergo colonoscopy and would inform the widespread efforts to increase colorectal cancer screening currently underway in the US.
Abstract and Introduction
Abstract
Our study aimed to determine, for patients who had undergone recent colonoscopy, associations between specific colonoscopy patient characteristics, exam characteristics and patients' perception of colonoscopy reducing their risk of dying from colorectal cancer. A cross-sectional analysis was conducted using data (2004–2008) from the New Hampshire Colonoscopy Registry, consisting of a Self-report Questionnaire, Colonoscopy Report form, and a Follow-up Questionnaire, which measured agreement responses to the statement, "Having a colonoscopy decreased my chances of dying from colon cancer". Chi-square tests and logistic regression were used to assess differences in patient responses by patient and colonoscopy characteristics. A majority of patients (N = 5,672, 81%) agreed that having a colonoscopy decreased their chances of dying from colon cancer. Patients with a personal history of polyps were more likely to agree that colonoscopy reduced their chances of dying compared to patients without prior polypectomy [OR (95% CI) = 1.34 (1.06, 1.69)] and patients with a family history of colorectal cancer were 33% more likely to agree to the statement than those without a family history [OR (95% CI) = 1.33 (1.12, 1.58)]. Personal history of polyps and family history of colorectal cancer are significant predictors of patients' positive perception of colonoscopy, suggesting that personal experience, rather than the potential preventive effect of colonoscopy itself, may influence the perceived benefit of colonoscopy. Intervention efforts should be made to effectively disseminate knowledge of the preventive benefit of colonoscopy.
Introduction
Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States, but only half of the appropriate population receives CRC screening. The US Preventive Services Task Force (USPSTF) has given CRC screening a grade of A in terms of evidence to support this type of screening, and recommends fecal occult blood testing, sigmoidoscopy, or colonoscopy among adults beginning at age of 50 (for those at average risk) and continuing until age 75. Screening guidelines have also been published by the American Cancer Society and the Multi-Society Task Force; these outline options for both screening and surveillance. The American Society of Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG) recommend colonoscopy as the optimal method for CRC screening; this is currently the most widely used method.
Colonoscopy is the only screening method able to prevent CRC through polypectomy, or the removal of polyps. Primary care providers (PCPs) are responsible for appropriately screening and educating their patients about CRC, including ensuring patient knowledge of the preventive benefit of colonoscopy. Improved understanding of patients' perceptions, particularly in relationship to motivation to undergo colonoscopy, would be essential to increasing patient compliance with screening.
Studies have investigated the relationships between specific patient characteristics—such as family and health history—and knowledge about screening in general as well as understanding of CRC risk. However, the relationship between individual colonoscopy patients' characteristics, exam characteristics (including polyp findings), and their perception of the benefit of colonoscopy screening is still unclear. Studies addressing patient perceptions are useful in understanding motivation to undergo colonoscopy and would inform the widespread efforts to increase colorectal cancer screening currently underway in the US.