title: Colonoscopy is the preferred colorectal cancer screening method in a population-based program.
abstract: OBJECTIVE
  Various screening methods for colorectal cancer (CRC) are promoted by professional societies; however, few data are available about the factors that determine patient participation in screening, which is crucial to the success of population-based programs. This study aimed (i) to identify factors that determine acceptance of screening and preference of screening method, and (ii) to evaluate procedure success, detection of colorectal neoplasia, and patient satisfaction with screening colonoscopy.
  
  
  METHODS
  Following a public awareness campaign, the population aged 50 - 80 years was offered CRC screening in the form of annual fecal occult blood tests, flexible sigmoidoscopy, a combination of both, or colonoscopy.
  
  
  RESULTS
  2731 asymptomatic persons (12.0 % of the target population) registered with and were eligible to take part in the screening program. Access to information and a positive attitude to screening were major determinants of participation. Colonoscopy was the method preferred by 74.8 % of participants. Advanced colorectal neoplasia was present in 8.5 %; its prevalence was higher in males and increased with age. Significant complications occurred in 0.5 % of those undergoing colonoscopy and were associated with polypectomy or sedation. Most patients were satisfied with colonoscopy and over 90 % would choose it again for CRC screening.
  
  
  CONCLUSIONS
  In this population-based study, only a small proportion of the target population underwent CRC screening despite an extensive information campaign. Colonoscopy was the preferred method and was safe. The determinants of participation in screening and preference of screening method, together with the distribution of colorectal neoplasia in different demographic categories, provide a rationale for improving screening procedures.
authors.affiliation: Division of Gastroenterology, Department of Medicine, District Hospital of Uri, Switzerland.
authors.forename: U A
authors.initials: UA
authors.lastname: Marbet
authors.forename: P
authors.initials: P
authors.lastname: Bauerfeind
authors.forename: J
authors.initials: J
authors.lastname: Brunner
authors.forename: G
authors.initials: G
authors.lastname: Dorta
authors.forename: J J
authors.initials: JJ
authors.lastname: Valloton
authors.forename: F
authors.initials: F
authors.lastname: Delcò
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006293:Health Promotion; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D013557:Switzerland / Q000453:epidemiology