Racial/ethnic differences in patient experiences with and preferences for computed tomography colonography and optical colonoscopy.
OBJECTIVE
Racial/ethnic minorities are less likely than whites to undergo colorectal cancer (CRC) screening. Although computed tomography colonography (CTC) is a less invasive alternative to optical colonoscopy (OC), it is not known whether CTC will increase acceptance of CRC screening in minorities.


METHODS
Patients undergoing OC for clinically indicated reasons had CTC followed by same-day OC. After the sedation from the OC had worn off, a questionnaire was administered to assess pain, discomfort, bloating, embarrassment, anxiety, and patient satisfaction using a 10-point scale (1 = least, 10 = greatest).


RESULTS
Of the 272 patients enrolled, there were 134 whites, 71 blacks, 53 Hispanics, and 14 who self-identified their race/ethnicity as other. Although the proportion of subjects who preferred CTC over OC was not significantly different (52.9% vs 47.1%, P = .36), racial/ethnic minorities were significantly less likely than whites to prefer CTC over OC (whites, 65.7%; blacks, 45.1%; Hispanics, 35.8%; and other, 35.7%; P < .001). Racial/ethnic minorities were less satisfied with CTC (whites, 8.4 +/- 1.7; blacks, 7.8 +/- 1.7; Hispanics, 7.4 +/- 1.8; and other, 7.5 +/- 2.1; P = .001) and were significantly less willing to undergo CTC again in the future (whites, 95.5%; blacks, 80.3%; Hispanics, 84.9%; and other, 85.7%; P = .006).


CONCLUSIONS
Compared with white patients, OC is better tolerated and is preferred over CTC for evaluation of the colon among racial/ethnic minorities. Although CTC is less invasive than OC, our findings suggest that CTC is unlikely to overcome racial/ethnic disparities in CRC screening.
Rajapaksa
Roshini C
RC
Division of Gastroenterology, New York University School of Medicine, New York, New York, USA.
Macari
Michael
M
Bini
Edmund J
EJ
D000368:Aged; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D017060:Patient Satisfaction; D044469:Racial Groups / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires