Screening for colorectal cancer: comparison of perceived test burden of guaiac-based faecal occult blood test, faecal immunochemical test and flexible sigmoidoscopy.

Abstract

BACKGROUND:

Perceived burden of colorectal cancer (CRC) screening is an important determinant of participation in subsequent screening rounds and therefore crucial for the effectiveness of a screening programme. This study determined differences in perceived burden and willingness to return for a second screening round among participants of a randomised population-based trial comparing a guaiac-based faecal occult blood test (gFOBT), a faecal immunochemical test (FIT) and flexible sigmoidoscopy (FS) screening.

METHODS:

A representative sample of the Dutch population (aged 50-74years) was randomised to be invited for gFOBT, FIT and FS screening. A random sample of participants of each group was asked to complete a questionnaire about test burden and willingness to return for CRC screening.

RESULTS:

In total 402/481 (84%) gFOBT, 530/659 (80%) FIT and 852/1124 (76%) FS screenees returned the questionnaire. The test was reported as burdensome by 2.5% of gFOBT, 1.4% of FIT and 12.9% of FS screenees (comparing gFOBT versus FIT p=0.05; versus FS p<0.001). In total 94.1% of gFOBT, 94.0% of FIT and 83.8% of FS screenees were willing to attend successive screening rounds (comparing gFOBT versus FIT p=0.84; versus FS p<0.001). Women reported more burden during FS screening than men (18.2% versus 7.7%; p<0.001).

CONCLUSIONS:

FIT slightly outperforms gFOBT with a lower level of reported discomfort and overall burden. Both FOBTs are better accepted than FS screening. All three tests have a high level of acceptance, which may affect uptake of subsequent screening rounds and should be taken into consideration before implementing a CRC screening programme.

• Authors: L Hol, V de Jonge, M E van Leerdam, M van Ballegooijen, C W N Looman, A J van Vuuren, J C I Y Reijerink, J D F Habbema, M L Essink-Bot, E J Kuipers
• Journal: European journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 46 Issue 11 Pg. 2059-66 (Jul 2010) ISSN: 1879-0852 [Electronic] England
• PMID: 20621736 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 Elsevier Ltd. All rights reserved.

Chemical References

• Indicators and Reagents
• Guaiac

Topics

• Aged
• Colorectal Neoplasms (diagnosis, psychology)
• Cost of Illness
• Early Detection of Cancer (methods, psychology)
• Female
• Guaiac
• Humans
• Immunologic Tests (methods)
• Indicators and Reagents
• Male
• Middle Aged
• Netherlands
• Occult Blood
• Pain (etiology)
• Patient Satisfaction
• Shame
• Sigmoidoscopy (methods, psychology)