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News

Informed choice vs no choice in colorectal cancer screening tests

This month's issue of the American Journal of Gastroenterology compares the level of adherence to colorectal cancer screening programs among screening participants offered vs. not offered informed choices.

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Dr Joseph Sung and colleauges from China compared the level of adherence to colorectal cancer screening programs among screening participants offered vs. not offered informed choices on screening modality.

The researchers recruited 10,606 screening participants aged 50–70 years, including 6,397 subjects who were offered a choice of yearly fecal immunochemical test (FIT) for up to 3 years vs. one colonoscopy, and 4,209 subjects who were offered either FIT or colonoscopy without choice.

The subjects were prospectively followed up for 3 years.

The proportion of screening participants who returned their specimens in all subsequent years, and the attendance rate of scheduled endoscopy appointment were compared between those with vs. without choice.

The proportion of subjects attending colonoscopy was 96%
American Journal of Gastroenterology

The adherence rate with FIT was 98%, 84%, and 73% in the first 3 years of follow-up, respectively, among those who were offered a choice.

The team noted that the adherence rate with FIT was 98%, 78%, and 63%, respectively, among those without choices.

The research team found that the proportion of subjects attending colonoscopy was 96%, and 91%.

From binary logistic regression analysis, participants who were offered informed choice were significantly more likely to adhere to the program when compared with those without test choices.

The team observed that the respective adjusted odds ratio for the FIT and colonoscopy groups was 1.6, and 2.5.

Dr Sung's team commented, "This study found that patients who were offered an informed choice for screening had higher adherence rates than patients who were not offered a choice in real-life practices, suggesting that providing screening test options for colorectal cancer screening is preferred."

Am J Gastroenterol 2014; 109:1072–1079
14 July 2014

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