Abstract
BackgroundColonoscopy is a valuable screening tool for colorectal cancer. However, patients experience anxiety when faced with attending a first colonoscopy, and negative attitudes may contribute to non-attendance. Few studies in Europe have explored these attitudes, despite increasing colorectal cancer incidence.Study aimWe conducted an online survey of the public in five European Union countries (France, Germany, Italy, Spain, and the UK), with the aim of understanding public knowledge of, perceptions of, and attitudes towards, colonoscopy and bowel preparation, amongst colonoscopy-naïve respondents. Attitudes towards colonoscopy were also gathered from colonoscopy-experienced patients.MethodsSurvey answers were gathered from 2,500 colonoscopy-naïve respondents and 500 colonoscopy-experienced patients, divided equally between countries.ResultsAcross Europe, 72% of colonoscopy-naïve respondents showed receptiveness to colonoscopy if advised by their doctor to receive one, but only 45% understood its use to prevent colorectal cancer. Forty-three percent of colonoscopy-experienced respondents would still be embarrassed about having another colonoscopy, although 59% said that the experience had been better than expected. Colonoscopy-experienced respondents had greater aversion to bowel preparation than colonoscopy-naïve respondents (47% vs 26%), and 67% of colonoscopy-naïve respondents thought that only 1 litre of bowel preparation or less is required. Italians and the Spanish wanted more information than on average in Europe, while Germans had more realistic expectations of bowel preparation.DiscussionThere are perceptual gaps amongst the public around the purpose of colonoscopies, the subjective experience of the colonoscopy procedure, and the quantity of bowel preparation needed. These concerns could be mitigated by better education and using lower-volume bowel preparation techniques.ConclusionEuropeans would have a colonoscopy, but its preventive medical purpose is poorly understood and there are misconceptions around the process. Further education about the procedure, its benefits and bowel preparation is vital to improve understanding and compliance.
Highlights
Colorectal cancer (CRC) is the third most common malignancy worldwide, and the second leading cause of cancer-related death [1]
Forty-three percent of colonoscopy-experienced respondents would still be embarrassed about having another colonoscopy, 59% said that the experience had been better than expected
Colonoscopy-experienced respondents had greater aversion to bowel preparation than colonoscopy-naïve respondents (47% vs 26%), and 67% of colonoscopy-naïve respondents thought that only 1 litre of bowel preparation or less is required
Summary
Colorectal cancer (CRC) is the third most common malignancy worldwide, and the second leading cause of cancer-related death [1]. In Europe for instance, in countries such as Italy, Spain and the UK, the incidence of CRC has increased over a recent 10-year period. In contrast with Europe, the incidence of CRC has decreased over 10 years in the USA, though the causes of this are ill-defined [2]. Colonoscopy is a valuable screening tool for colorectal cancer. Patients experience anxiety when faced with attending a first colonoscopy, and negative attitudes may contribute to non-attendance. Few studies in Europe have explored these attitudes, despite increasing colorectal cancer incidence. We conducted an online survey of the public in five European Union countries (France, Germany, Italy, Spain, and the UK), with the aim of understanding public knowledge of, perceptions of, and attitudes towards, colonoscopy and bowel preparation, amongst colonoscopynaïve respondents.
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