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Public preferences for using quantitative faecal immunochemical test (FIT) vs colonoscopy (CC) as diagnostic test for colorectal cancer: Evidence from an online survey

Von Wagner, C; Verstraete, W; Hirst, M; Nicholson, BD; Stoffel, S; Laszlo, H; (2019) Public preferences for using quantitative faecal immunochemical test (FIT) vs colonoscopy (CC) as diagnostic test for colorectal cancer: Evidence from an online survey. BJGP Open , 17 , Article 182. 10.3399/bjgpopen20X101007. Green open access

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Abstract

Background: There has been interest in using the non-invasive, home-based quantitative faecal immunochemical test (FIT) to rule out colorectal cancer (CRC) in high-risk symptomatic patients. Aim: To elicit public preferences for FIT versus colonoscopy (CC) and its delivery in primary care. Design & setting: A cross-sectional online survey in England. Method: A total of 1057 adults (without CRC symptoms and diagnosis) aged 40–59 years were invited from an English online survey panel. Responders were asked to imagine they had been experiencing CRC symptoms that would qualify them for a diagnostic test. Participants were presented with choices between CC and FIT in ascending order of number of CRCs missed by FIT (from 1–10%). It was measured at what number of missed CRCs responders preferred CC over FIT. Results: While 150 participants did not want either of the tests when both missed 1% CRCs, the majority (n = 741, 70.0%) preferred FIT to CC at that level of accuracy. However, this preference reduced to 427 (40.4%) when FIT missed one additional cancer. Women were more likely to tolerate missing CRC when using FIT. Having lower numeracy and perceiving a higher level of risk meant participants were less likely to tolerate a false negative test. Most of those who chose FIT preferred to return it by mail (62.2%), to be informed about normal test results by letter (42.1%), and about abnormal test results face to face (32.5%). Conclusion: While the majority of participants preferred FIT over CC when both tests had the same sensitivity, tolerance for missed CRCs was low.

Type: Article
Title: Public preferences for using quantitative faecal immunochemical test (FIT) vs colonoscopy (CC) as diagnostic test for colorectal cancer: Evidence from an online survey
Open access status: An open access version is available from UCL Discovery
DOI: 10.3399/bjgpopen20X101007
Publisher version: https://doi.org/10.3399/bjgpopen20X101007
Language: English
Additional information: This article is Open Access: CC BY license (https://creativecommons.org/licenses/ by/4.0/)
Keywords: diagnostic tests, preference elicitation, choice experiment, colorectal neoplasms, primary health care, surveys and questionnaires
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/10082825
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