title: Burden of colonoscopy compared to non-cathartic CT-colonography in a colorectal cancer screening programme: randomised controlled trial.
abstract: OBJECTIVE
  CT-colonography has been suggested to be less burdensome for primary colorectal cancer (CRC) screening than colonoscopy. To compare the expected and perceived burden of both in a randomised trial.
  
  
  METHODS
  8844 Dutch citizens aged 50-74 years were randomly invited for CRC screening with colonoscopy (n=5924) or CT-colonography (n=2920). Colonoscopy was performed after full colon lavage, or CT-colonography after limited bowel preparation (non-cathartic). All invitees were asked to complete the expected burden questionnaire before the procedure. All participants were invited to complete the perceived burden questionnaire 14 days later. Mean scores were calculated on 5-point scales.
  
  
  RESULTS
  Expected burden: 2111 (36%) colonoscopy and 1199 (41%) CT-colonography invitees completed the expected burden questionnaire. Colonoscopy invitees expected the bowel preparation and screening procedure to be more burdensome than CT-colonography invitees: mean scores 3.0±1.1 vs 2.3±0.9 (p<0.001) and 3.1±1.1 vs 2.2±0.9 (p<0.001). Perceived burden: 1009/1276 (79%) colonoscopy and 801/982 (82%) CT-colonography participants completed the perceived burden questionnaire. The full screening procedure was reported as more burdensome in CT-colonography than in colonoscopy: 1.8±0.9 vs 2.0±0.9 (p<0.001). Drinking the bowel preparation resulted in a higher burden score in colonoscopy (3.0±1.3 vs 1.7±1.0, p<0.001) while related bowel movements were scored more burdensome in CT-colonography (2.0±1.0 vs 2.2±1.1, p<0.001). Most participants would probably or definitely take part in a next screening round: 96% for colonoscopy and 93% for CT-colonography (p=0.99).
  
  
  CONCLUSIONS
  In a CRC screening programme, colonoscopy invitees expected the screening procedure and bowel preparation to be more burdensome than CT-colonography invitees. In participants, CT-colonography was scored as more burdensome than colonoscopy. Intended participation in a next screening round was comparable.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: de Wijkerslooth
authors.forename: Margriet C
authors.initials: MC
authors.lastname: de Haan
authors.forename: Esther M
authors.initials: EM
authors.lastname: Stoop
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: Maarten
authors.initials: M
authors.lastname: Thomeer
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: Monique E
authors.initials: ME
authors.lastname: van Leerdam
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
authors.forename: Evelien
authors.initials: E
authors.lastname: Dekker
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D002400:Cathartics / Q000008:administration & dosage; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000379:methods
chemical_list: D002400:Cathartics