title: Patient-reported outcomes following flexible sigmoidoscopy screening for colorectal cancer in a demonstration screening programme in the UK.
abstract: OBJECTIVE
  Flexible sigmoidoscopy (FS) screening for colorectal cancer will be introduced into the National Cancer Screening Programmes in England in 2013. Patient-reported outcome measures (PROMs) from trial participants indicate high acceptability and no adverse physical or psychological consequences, but this may not generalize to routine screening in the community. This study examined PROMs in a community-based FS screening programme.
  
  
  METHODS
  Eligible adults aged 58-59 (n = 2016) registered at 34 London general practices were mailed a National Health Service-endorsed invitation to attend FS screening. Pain and side-effects were assessed in a 'morning-after' questionnaire, and satisfaction was assessed in a three-month follow-up questionnaire. Anxiety, self-rated health and colorectal symptoms were assessed at prescreening and follow-up.
  
  
  RESULTS
  In total, 1020 people attended screening and were included in the current analyses, of whom 913 (90%) returned the morning-after questionnaire, and 674 (66%) the follow-up questionnaire. The prescreening questionnaire had been completed by 751 (74%) of those who attended. The majority (87%) of respondents reported no pain or mild pain, and the most frequent side-effect (wind) was only experienced more than mildly by 16%. Satisfaction was extremely high, with 98% glad they had the test; 97% would encourage a friend to have it. From prescreening to follow-up there were no changes in anxiety or self-rated health, and the number of colorectal symptoms declined. Satisfaction and changes in wellbeing were not moderated by gender, deprivation, ethnicity or screening outcome.
  
  
  CONCLUSIONS
  PROMs indicate high acceptability of FS screening in 58-59 year olds, with no adverse effects on colorectal symptoms, health status or psychological wellbeing.
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, MRC/CSO Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK. Katie.Robb@glasgow.ac.uk
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Robb
authors.forename: Siu Hing
authors.initials: SH
authors.lastname: Lo
authors.forename: Emily
authors.initials: E
authors.lastname: Power
authors.forename: Ines
authors.initials: I
authors.lastname: Kralj-Hans
authors.forename: Robert
authors.initials: R
authors.lastname: Edwards
authors.forename: Maggie
authors.initials: M
authors.lastname: Vance
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
authors.forename: Wendy
authors.initials: W
authors.lastname: Atkin
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000009:adverse effects / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010149:Postoperative Pain / Q000453:epidemiology / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D011379:Prognosis; D057566:Self Report; D012812:Sigmoidoscopy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology