The impact of patient-reported factors of endoscopic screening experience on attendance at future examinations and distal colorectal cancer incidence
File(s)
Published version
Author(s)
Power, Sharon
Wooldrage, Kate
Thomas-Gibson, Siwan
Cross, Amanda
Type
Journal Article
Abstract
Background
Endoscopic examinations can reduce colorectal cancer (CRC) burden through early detection and removal of precancerous lesions; however, after initial endoscopy, some patients do not attend subsequent examinations.
Aims
To investigate the impact of patient experience of endoscopic screening on attendance at future examinations and distal CRC incidence.
Methods
In a cohort study including 40,141 participants who received flexible sigmoidoscopy (FS) screening in the UK FS Screening Trial, median follow-up was 16.8 years. We examined family history of CRC, bowel preparation quality, segment of bowel reached, and responses to patient-reported post-examination questionnaires. We estimated multivariable odds ratios (OR) for attendance at future examinations by logistic regression and hazard ratios (HR) for associations between patient experience at FS and distal CRC incidence.
Results
Of those recommended a future endoscopy, 7.1% did not attend repeat FS, 3.4% did not attend colonoscopy, 18.3% did not attend surveillance, and 0.5% developed distal CRC. Symptoms of faintness/dizziness (OR = 5.10 95%CI 1.49–17.42) were associated with non-attendance at repeat FS. Non-attendance at surveillance was associated with whether participants felt they had made the right decision to take the tests; that taking the tests was tempting fate; that they needed the tests; or that they would rather have let nature take its course. A FS more painful than expected (HR = 0.57 95%CI 0.37–0.88) was inversely associated with distal CRC incidence.
Conclusions
We identified aspects of patient experience at endoscopy that could be used to improve attendance at future endoscopic examinations, which in turn could reduce CRC incidence. Trial registration number: ISRCTN28352761. Trial registration date: April 2000.
Endoscopic examinations can reduce colorectal cancer (CRC) burden through early detection and removal of precancerous lesions; however, after initial endoscopy, some patients do not attend subsequent examinations.
Aims
To investigate the impact of patient experience of endoscopic screening on attendance at future examinations and distal CRC incidence.
Methods
In a cohort study including 40,141 participants who received flexible sigmoidoscopy (FS) screening in the UK FS Screening Trial, median follow-up was 16.8 years. We examined family history of CRC, bowel preparation quality, segment of bowel reached, and responses to patient-reported post-examination questionnaires. We estimated multivariable odds ratios (OR) for attendance at future examinations by logistic regression and hazard ratios (HR) for associations between patient experience at FS and distal CRC incidence.
Results
Of those recommended a future endoscopy, 7.1% did not attend repeat FS, 3.4% did not attend colonoscopy, 18.3% did not attend surveillance, and 0.5% developed distal CRC. Symptoms of faintness/dizziness (OR = 5.10 95%CI 1.49–17.42) were associated with non-attendance at repeat FS. Non-attendance at surveillance was associated with whether participants felt they had made the right decision to take the tests; that taking the tests was tempting fate; that they needed the tests; or that they would rather have let nature take its course. A FS more painful than expected (HR = 0.57 95%CI 0.37–0.88) was inversely associated with distal CRC incidence.
Conclusions
We identified aspects of patient experience at endoscopy that could be used to improve attendance at future endoscopic examinations, which in turn could reduce CRC incidence. Trial registration number: ISRCTN28352761. Trial registration date: April 2000.
Date Issued
2025-03-06
Date Acceptance
2025-02-19
Citation
BMC Cancer, 2025, 25
ISSN
1471-2407
Publisher
BMC
Journal / Book Title
BMC Cancer
Volume
25
Copyright Statement
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1186/s12885-025-13771-3
Subjects
Colonoscopy
Colorectal cancer
Flexible sigmoidoscopy
Patient experience
Patient satisfaction
Publication Status
Published
Article Number
409
Date Publish Online
2025-03-06