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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Screening behavior of individuals at high risk for colorectal cancer
Eveline M A Bleiker1, Fred H Menko, Babs G Taal
1Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leewenhoek Hospital, Amsterdam, The Netherlands. e.bleiker@nkl.nl
Gastroenterology
|February 3, 2005
Summary
While few high-risk individuals skip colorectal cancer screening, about 25% delay it. Reducing discomfort and using reminders can improve adherence to periodic colonoscopies.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- Periodic colonoscopy significantly reduces colorectal cancer incidence and mortality in high-risk individuals.
- Familial colorectal cancer (FCRC) and hereditary nonpolyposis colorectal cancer (HNPCC) represent high-risk populations requiring screening.
- Understanding compliance and noncompliance factors is crucial for effective screening strategies.
Purpose of the Study:
- To assess compliance rates with periodic colonoscopy screening.
- To identify factors significantly associated with noncompliance or delayed screening in high-risk individuals.
- To explore strategies for enhancing screening adherence.
Main Methods:
- A self-report questionnaire on psychosocial issues and screening experiences was administered to 178 individuals advised on periodic screening.
- Compliance data were collected from medical records and self-reports.
- Statistical analysis was performed to identify significant predictors of noncompliance/delay.
Main Results:
- 84% of participants (149 individuals) completed the study.
- Complete noncompliance was rare (3%), but approximately 25% experienced significant delays (>1 year) in screening.
- Perceived barriers like discomfort and embarrassment were significantly linked to noncompliance/delay (OR, 1.2; 95% CI, 1.1-1.3).
- Sedative use and reminder letters appeared to improve compliance.
Conclusions:
- While outright screening refusal is uncommon, a substantial proportion of high-risk individuals do not adhere to recommended screening frequencies.
- Addressing procedural discomfort and embarrassment is key to improving screening adherence.
- Implementing reminder systems can enhance compliance with periodic colonoscopies for high-risk populations.
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