title: Reasons for participation and nonparticipation in colorectal cancer screening: a randomized trial of colonoscopy and CT colonography.
abstract: OBJECTIVE
  We compared reported reasons for participation and nonparticipation in colorectal cancer (CRC) screening between colonoscopy and computed tomographic (CT) colonography in a randomized controlled trial.
  
  
  METHODS
  We randomly invited 8,844 people for screening by colonoscopy or CT colonography. On a questionnaire, invitees indicated reasons for participation or nonparticipation and indicated the most decisive reason.
  
  
  RESULTS
  The most frequently cited reasons to accept screening were early detection of precursor lesions and CRC, and contribution to science. The most frequently cited reasons to decline were the unpleasantness of the examination, the inconvenience of the preparation, a lack of symptoms, and "no time/too much effort." Among colonoscopy nonparticipants, elderly invitees cited inconvenience less often, and absence of symptoms more often, than did the group overall. The reason reported most frequently as the most decisive reason not to participate was the unpleasantness of the examination among colonoscopy nonparticipants, and "no time/too much effort" and lack of symptoms among CT colonography nonparticipants.
  
  
  CONCLUSIONS
  In light of these results, future screening programs could tailor the information provided to invitees.
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: Monique E
authors.initials: ME
authors.lastname: van Leerdam
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
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: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D023881:Colonography, Computed Tomographic / Q000706:statistics & numerical data; D003113:Colonoscopy / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012494:Sampling Studies; D017678:Sex Distribution; D012737:Sex Factors; D011795:Surveys and Questionnaires