Patients Prefer CT Colonography Over Colonoscopy

Abstract

Purpose: The early detection and removal of adenomatous polyps reduces mortality associated with colorectal cancer (CRC). While colonoscopy is the preferred test for CRC screening and prevention, the invasive and time consuming nature of the test are often cited as reasons for non-compliance with this form of screening. Computed tomography colonography (CTC) is a less invasive screening method that has been shown to have accuracy comparable to colonoscopy for the detection of colorectal neoplasia. The aim of the project was to assess patient preferences between colonoscopy and CTC screening in an open access, no-fee system. Methods: 250 consecutive, average risk, asymptomatic patients undergoing CRC screening at the National Naval Medical Center completed a survey which assessed (Q1) reasons for choosing CTC in lieu of colonoscopy, (Q2) compliance with CRC screening if CTC was not offered, and (3) which of the two tests they preferred, for individuals who had undergone colonoscopy in the past. Results: The most common reasons for undergoing CTC in lieu of colonoscopy included the superior convenience (33.6 %), recommendation by referring provider (13.2 %), and lower complication rates of CTC (10.8 %) (Table 1). Had CTC not been an option (Q2), 91/250 (36.4 %) patients would have forgone CRC screening. Among the 57 patients who had experienced both procedures (Q3), 94.7 % (n=54) preferred CTC, 0.8 % (n=2) preferred colonoscopy, and 0.4 % (n=1) did not have a preference.TableConclusion: At our institution, where CTC has been successfully integrated into a Gastroenterology practice, the primary reason for patients to undergo this test was convenience. Importantly, had CTC not been a CRC screening option, approximately one third of patients surveyed would have not obtained screening for CRC. Patients who have undergone both colonoscopy and CTC at our institution much prefer CTC. These data support the importance of having CTC as an alternative screening option.