Using a hypothetical scenario to assess public preferences for colorectal surveillance following screening-detected, intermediate-risk adenomas: annual home-based stool test vs. triennial colonoscopy.
BACKGROUND
To assess public preferences for colorectal cancer (CRC) surveillance tests for intermediate-risk adenomas, using a hypothetical scenario.


METHODS
Adults aged 45-54 years without CRC were identified from three General Practices in England (two in Cumbria, one in London). A postal survey was carried out during a separate study on preferences for different first-line CRC screening modalities (non- or full-laxative computed tomographic colonography, flexible sigmoidoscopy, or colonoscopy). Individuals were allocated at random to receive a pack containing information on one first-line test, and a paragraph describing CRC surveillance recommendations for people who are diagnosed with intermediate-risk adenomas during screening. All participants received a description of two surveillance options: annual single-sample, home-based stool testing (consistent with Faecal Immunochemical Tests; FIT) or triennial colonoscopy. Invitees were asked to imagine they had been diagnosed with intermediate-risk adenomas, and then complete a questionnaire on their surveillance preferences.


RESULTS
22.1 % (686/3,100) questionnaires were returned. 491 (15.8 %) were eligible for analysis. The majority of participants stated a surveillance preference for the stool test over colonoscopy (60.8 % vs 31.0 %; no preference: 8.1 %; no surveillance: 0.2 %). Women were more likely to prefer the stool test than men (66.7 % vs. 53.6 %; p = .011). The primary reason for preferring the stool test was that it would be done more frequently. The main reason to prefer colonoscopy was its superiority at finding polyps.


CONCLUSIONS
A majority of participants stated a preference for a surveillance test resembling FIT over colonoscopy. Future research should test whether this translates to greater adherence in a real surveillance setting.


BACKGROUND
International Standard Randomised Controlled Trial Number registry, ISRCTN85697880 , prospectively registered on 25/04/2013.
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Bernardette
B
Bonello
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Alex
A
Ghanouni
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Harriet L
HL
Bowyer
Department of Surgery and Cancer, Imperial College London, London, UK.
Eilidh
E
MacRae
Department of Surgery and Cancer, Imperial College London, London, UK.
Wendy
W
Atkin
NHS Bowel Cancer Screening Southern Programme Hub, Guildford, Surrey, UK.|Royal Surrey County Hospital NHS Foundation Trust & University of Surrey, Guildford, Surrey, UK.
Stephen P
SP
Halloran
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Jane
J
Wardle
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. c.wagner@ucl.ac.uk.
Christian
C
von Wagner
D000236:Adenoma / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D003113:Colonoscopy / Q000379:methods / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D057240:Patient Preference; D011159:Population Surveillance / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors
Cancer surveillance; Colonoscopy; Colorectal cancer; Faecal immunochemical test; Intermediate-risk adenomas; Patient preference