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Colonoscopy vs non-cathartic CT-colonography in colorectal cancer screening

A study in the latest issue of Gut examines the burden of colonoscopy compared to non-cathartic CT-colonography in a colorectal cancer screening program.

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CT-colonography has been suggested to be less burdensome for primary colorectal cancer screening than colonoscopy.

Dr Thomas de Wijkerslooth and colleagues from the Netherlands compared the expected and perceived burden of both in a randomized trial.

The team identified 8844 Dutch citizens aged 5074 years who were randomly invited for colorectal cancer screening with colonoscopy or CT-colonography.

The team performed colonoscopy after full colon lavage, or CT-colonography after limited bowel preparation.

All invitees were asked to complete the expected burden questionnaire before the procedure.

The perceived burden was 79% with colonoscopy
Gut

All participants were invited to complete the perceived burden questionnaire 14 days later.

The researchers found that the expected burden was 36% with colonoscopy, and 41% of CT-colonography invitees completed the expected burden questionnaire.

Colonoscopy invitees expected the bowel preparation and screening procedure to be more burdensome than CT-colonography invitees.

The team observed that the perceived burden was 79% with colonoscopy, and 82% of CT-colonography participants completed the perceived burden questionnaire.

The full screening procedure was reported as more burdensome in CT-colonography than in colonoscopy.

Drinking the bowel preparation resulted in a higher burden score in colonoscopy while related bowel movements were scored more burdensome in CT-colonography.

Most participants would probably or definitely take part in a next screening round, at 96% for colonoscopy and 93% for CT-colonography.

Dr de Wijkerslooth's team commented, "In a colorectal cancer screening program, colonoscopy invitees expected the screening procedure and bowel preparation to be more burdensome than CT-colonography invitees."

"In participants, CT-colonography was scored as more burdensome than colonoscopy. Intended participation in a next screening round was comparable."

Gut 2012; 61: 1552-1559
08 October 2012

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