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European Radiology
Published in: European Radiology 3/2017

Open Access 01-03-2017 | Gastrointestinal

Patient experience of CT colonography and colonoscopy after fecal occult blood test in a national screening programme

Authors: Andrew A. Plumb, Alex Ghanouni, Colin J. Rees, Paul Hewitson, Claire Nickerson, Suzanne Wright, Stuart A. Taylor, Steve Halligan, Christian von Wagner

Published in: European Radiology | Issue 3/2017

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Abstract

Objective

To investigate patient experience of CT colonography (CTC) and colonoscopy in a national screening programme.

Methods

Retrospective analysis of patient experience postal questionnaires. We included screenees from a fecal occult blood test (FOBt) based screening programme, where CTC was performed when colonoscopy was incomplete or deemed unsuitable. We analyzed questionnaire responses concerning communication of test risks, test-related discomfort and post-test pain, as well as complications. CTC and colonoscopy responses were compared using multilevel logistic regression.

Results

Of 67,114 subjects identified, 52,805 (79 %) responded. Understanding of test risks was lower for CTC (1712/1970 = 86.9 %) than colonoscopy (48783/50975 = 95.7 %, p < 0.0001). Overall, a slightly greater proportion of screenees found CTC unexpectedly uncomfortable (506/1970 = 25.7 %) than colonoscopy (10,705/50,975 = 21.0 %, p < 0.0001). CTC was tolerated well as a completion procedure for failed colonoscopy (unexpected discomfort; CTC = 26.3 %: colonoscopy = 57.0 %, p < 0.001). Post-procedural pain was equally common (CTC: 288/1970,14.6 %, colonoscopy: 7544/50,975,14.8 %; p = 0.55). Adverse event rates were similar in both groups (CTC: 20/2947 = 1.2 %; colonoscopy: 683/64,312 = 1.1 %), but generally less serious with CTC.

Conclusions

Even though CTC was reserved for individuals either unsuitable for or unable to complete colonoscopy, we found only small differences in test-related discomfort. CTC was well tolerated as a completion procedure and was extremely safe. CTC can be delivered across a national screening programme with high patient satisfaction.

Key Points

• High patient satisfaction at CTC is deliverable across a national screening programme.
• Patients who cannot tolerate screening colonoscopy are likely to find CTC acceptable.
• CTC is extremely safe; complications are rare and almost never serious.
• Patients may require more detailed information regarding the expected discomfort of CTC.
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Metadata
Title
Patient experience of CT colonography and colonoscopy after fecal occult blood test in a national screening programme
Authors
Andrew A. Plumb
Alex Ghanouni
Colin J. Rees
Paul Hewitson
Claire Nickerson
Suzanne Wright
Stuart A. Taylor
Steve Halligan
Christian von Wagner
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4428-x

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