title: Comparison of patient preferences for fecal immunochemical test or colonoscopy using the analytic hierarchy process.
abstract: BACKGROUND
  In average-risk individuals aged 50 to 75 years, there is no difference in life-years gained when comparing colonoscopy every 10 years vs. annual fecal immunochemical testing (FIT) for colorectal cancer screening. Little is known about the preferences of patients when they have experienced both tests.
  
  
  METHODS
  The study was conducted with 954 patients from the University of Iowa Hospital and Clinics during 2010 to 2011. Patients scheduled for a colonoscopy were asked to complete a FIT before the colonoscopy preparation. Following both tests, patients completed a questionnaire which was based on an analytic hierarchy process (AHP) decision-making model.
  
  
  RESULTS
  In the AHP analysis, the test accuracy was given the highest priority (0.457), followed by complications (0.321), and test preparation (0.223). Patients preferred colonoscopy (0.599) compared with FIT (0.401) when considering accuracy; preferred FIT (0.589) compared with colonoscopy (0.411) when considering avoiding complications; and preferred FIT (0.650) compared with colonoscopy (0.350) when considering test preparation. The overall aggregated priorities were 0.517 for FIT, and 0.483 for colonoscopy, indicating patients slightly preferred FIT over colonoscopy. Patients' preferences were significantly different before and after provision of detailed information on test features (p < 0.0001).
  
  
  CONCLUSIONS
  AHP analysis showed that patients slightly preferred FIT over colonoscopy. The information provided to patients strongly affected patient preference. Patients' test preferences should be considered when ordering a colorectal cancer screening test.
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA. yinghui-xu@uiowa.edu.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA. barcey-levy@uiowa.edu.|Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA. barcey-levy@uiowa.edu.
authors.forename: Barcey T
authors.initials: BT
authors.lastname: Levy
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA. jeanette-daly@uiowa.edu.
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Daly
authors.affiliation: Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA. george-bergus@uiowa.edu.
authors.forename: George R
authors.initials: GR
authors.lastname: Bergus
authors.affiliation: Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA. Jeffrey-dunkelberg@uiowa.edu.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Dunkelberg
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis; D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007120:Immunochemistry; D007484:Iowa; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D057240:Patient Preference; D012306:Risk; D011795:Surveys and Questionnaires