Nearly all individuals screened with virtual colonoscopy are satisfied enough to say that they prefer the exam for future colorectal cancer screening, according to a study presented at last month's Digestive Disease Week meeting in Chicago.
In fact, some patients said they would skip screening entirely if virtual colonoscopy (also known as CT colonography or CTC) were unavailable, suggesting that VC might increase screening compliance among individuals who are hesitant to undergo conventional colonoscopy.
The multicenter study surveyed colorectal screening patients about their attitudes toward their experience and toward future screening. The study was conducted by Dr. Mark Damiano, Dr. Brooks Cash, and colleagues from the National Naval Medical Center (NNMC) in Bethesda, MD, along with investigators from two other facilities. Patients were drawn from the following facilities:
- Military tertiary medical center (NNMC, n = 297)
- University-affiliated CTC center (University of Wisconsin Health Center, n = 836)
- Private-practice CTC center (Colon Health Center of Delaware, n = 273)
The study isn't intended to set up some kind of competition between conventional colonoscopy and virtual colonoscopy, said Cash, who is chief of gastroenterology at NNMC, in an interview with AuntMinnie.com. Rather, he said, "comparisons between experiences are valuable and will help make each procedure that much more valuable in the future." That said, results are somewhat "biased" by the fact that all of the patients chose virtual colonoscopy for screening, he added.
Even though CTC is a less-invasive screening option that is comparable in accuracy to colonoscopy for detecting advanced neoplasia, its effect on overall screening rates is unknown. The current study assessed patient opinions and preferences in three very different practice settings, Cash said.
The researchers asked patients to fill out a 12-question survey upon completion of their CTC exam, with the data pooled and analyzed separately by site.
Among the 1,406 patients completing the survey (mean age, 50.7 years; 50.3% female), virtual colonoscopy was the first colorectal screening exam for 64.9% of the patients -- 72.2% of whom had delayed screening beyond the recommended age, the authors reported in an abstract accompanying the presentation. Overall, 87.3% of the patients were Caucasian.
The researchers also found that 92.9% of patients reported the screening experience as "good" or "excellent," and only 7% reported pain during the CTC procedure. Among the 441 patients who had also undergone conventional colonoscopy, 77.1% preferred CTC. In addition, 93% of all screening subjects said they would prefer virtual colonoscopy for their next screening exam, while just 6.4% said they would pursue conventional colonoscopy for their next screening.
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| Most patients reported "good" or "excellent" experience with CTC. All images courtesy of Dr. Brooks Cash. |
If CTC had not been available, 8.4% said they would have foregone colorectal cancer screening, and 21.4% expressed uncertainty about colonoscopy.
While there were multiple statistically significant survey responses by site, the trends to responses among all survey sites were similar, the authors reported.
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These findings demonstrate the importance of providing high-quality alternative colon cancer screening options based on increased screening of the target population, favorable patient opinions of the exam, and a willingness to undergo repeat procedures, they said.
The results suggest that providing CTC in addition to colonoscopy could improve screening adherence by nearly 30%. They also highlight the similarities and differences of patient perceptions and experiences in a variety of practice settings, the authors concluded.
"I think the most important answer that came out of our survey was [to the question], 'If CTC hadn't been offered, would you have pursued colorectal cancer screening?' " Cash said. "The fact that 8% said 'no' and another 21% said they weren't sure tells me we're getting people off the sidelines, and that's the whole purpose, in my mind, of a disruptive technology for colon screening."
