[Acceptance of screening colonoscopy for the prevention of colorectal cancer]

Morbidity and mortality in colorectal cancer are on the rise. Colonoscopy and polypectomy helps to decrease the incidence of colorectal cancer by 75%. This is the first analysis acceptance of screening colonoscopies in Poland.

The study was designed to (1) analyze common reasons for consent or refusal to undergo colonoscopy; (2) review the value of diverse sources of information on colonoscopy; (3) determine whether participation in screening colonoscopy programme was connected with participation in other screening examinations; (4) examine the range of pathologic findings; and (5) detect various pathological findings and their location.

Two groups of subjects aged 40-65 years were formed: I--consenting to colonoscopy (n=1000) and II--refusing to undergo the examination (n=200). Subjects aged 40-49 years were included when at least one of their first-degree relatives was previously diagnosed with colorectal cancer. Lack of any sign of cancer was requisite for enrollment. Data was extracted from questionnaires filled before and after the examination.

The most common reason for consent to colonoscopy was prophylaxis, while refusal was usually due to fear of pain. The most convincing sources of information on colonoscopy were the media. Persons who undergo screening tests for other cancers were more inclined to undergo screening colonoscopy as well. Bowel preparation was more difficult and more inconvenient than the examination itself. Screening colonoscopies are valuable because they enable detection of cancer and adenomatous polyps in asymptomatic patients. Rectosigmoidoscopy would fail to disclose the pathology in 20% of our subjects found positive by colonoscopy.