title: Non- or full-laxative CT colonography vs. endoscopic tests for colorectal cancer screening: a randomised survey comparing public perceptions and intentions to undergo testing.
abstract: OBJECTIVE
  Compare public perceptions and intentions to undergo colorectal cancer screening tests following detailed information regarding CT colonography (CTC; after non-laxative preparation or full-laxative preparation), optical colonoscopy (OC) or flexible sigmoidoscopy (FS).
  
  
  METHODS
  A total of 3,100 invitees approaching screening age (45-54 years) were randomly allocated to receive detailed information on a single test and asked to return a questionnaire. Outcomes included perceptions of preparation and test tolerability, health benefits, sensitivity and specificity, and intention to undergo the test.
  
  
  RESULTS
  Six hundred three invitees responded with valid questionnaire data. Non-laxative preparation was rated more positively than enema or full-laxative preparations [effect size (r) = 0.13 to 0.54; p < 0.0005 to 0.036]; both forms of CTC and FS were rated more positively than OC in terms of test experience (r = 0.26 to 0.28; all p-values < 0.0005). Perceptions of health benefits, sensitivity and specificity (p = 0.250 to 0.901), and intention to undergo the test (p = 0.213) did not differ between tests (n = 144-155 for each test).
  
  
  CONCLUSIONS
  Despite non-laxative CTC being rated more favourably, this study did not find evidence that offering it would lead to substantially higher uptake than full-laxative CTC or other methods. However, this study was limited by a lower than anticipated response rate.
  
  
  CONCLUSIONS
  • Improving uptake of colorectal cancer screening tests could improve health benefits • Potential invitees rate CTC and flexible sigmoidoscopy more positively than colonoscopy • Non-laxative bowel preparation is rated better than enema or full-laxative preparations • These positive perceptions alone may not be sufficient to improve uptake • Health benefits and accuracy are rated similarly for preventative screening tests.
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, Gower Street, London, WC1E 6BT, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Ghanouni
authors.forename: Steve
authors.initials: S
authors.lastname: Halligan
authors.forename: Andrew
authors.initials: A
authors.lastname: Plumb
authors.forename: Darren
authors.initials: D
authors.lastname: Boone
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
mesh_terms: D023881:Colonography, Computed Tomographic / Q000379:methods*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer / Q000379:methods*; D004733:Enema; D005260:Female; D006801:Humans; D033182:Intention; D054368:Laxatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011639:Public Opinion; D015203:Reproducibility of Results; D012812:Sigmoidoscopy / Q000379:methods; D016037:Single-Blind Method; D011795:Surveys and Questionnaires
chemical_list: D054368:Laxatives