Patient perceptions of stool-based DNA testing for colorectal cancer screening.
OBJECTIVE
Stool-based DNA (SB-DNA) testing is an emerging colorectal cancer screening strategy that offers a convenient, noninvasive, and potentially more acceptable alternative to existing screening tests. The objectives of this study were to compare patient perceptions of SB-DNA testing, fecal occult blood testing (FOBT), and colonoscopy, and elicit screening preferences.


METHODS
A prospective survey was conducted between August 2001 and March 2003 of asymptomatic, mostly average-risk subjects aged > or =50 years who were participating in a multicenter comparison of SB-DNA testing and FOBT for detecting colorectal neoplasia. Subjects completed a 25-item questionnaire within 48 hours after undergoing a colonoscopy, which served as the standard. Respondents were asked to rate each of the three screening tests on various prep- and test-related features, using a five-point ordinal scale or yes/no format, and to select a preferred strategy.


RESULTS
A total of 4042 subjects completed the survey (84% response rate). SB-DNA testing received the same or higher mean ratings than FOBT for most prep- and test-related features. When compared with colonoscopy, SB-DNA testing received higher ratings for all prep- and test-related features except perceived accuracy, where colonoscopy was rated higher. Overall, a higher percentage of patients preferred SB-DNA testing (45%) to both FOBT (32%) and colonoscopy (15%) for routine screening (p <0.001); 8% had no preference.


CONCLUSIONS
Patients willing to undergo colonoscopy, SB-DNA testing, and FOBT perceive SB-DNA testing to have a number of advantages over the other two tests. Moreover, many such patients prefer SB-DNA testing to FOBT and colonoscopy for routine screening.
Schroy
Paul C
PC
Department of Medicine, Boston Medical Center, Boston, MA 02118, USA. paul.schroy@bmc.org
Heeren
Timothy C
TC
D000368:Aged; D001294:Attitude to Health; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D004273:DNA, Neoplasm / Q000032:analysis*; D005243:Feces / Q000737:chemistry*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data*; D008875:Middle Aged; D009780:Occult Blood; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D014481:United States
D004273:DNA, Neoplasm