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Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study

Kaushal, A; Stoffel, ST; Kerrison, R; von Wagner, C; (2020) Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study. BMJ Open , 10 (7) , Article e035264. 10.1136/bmjopen-2019-035264. Green open access

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Abstract

Objectives: In England, a significant proportion of people who take part in the national bowel cancer screening programme (BCSP) and have a positive faecal occult blood test (FOBt) result, do not attend follow-up colonoscopy (CC). The aim of this study was to investigate differences in intended participation in a follow-up investigation by diagnostic modality offered including CC, CT colonography (CTC) or capsule endoscopy (CE). Setting: We performed a randomised online experiment with individuals who had previously completed an FOBt as part of the English BCSP. Methods: Participants (n=953) were randomly allocated to receive one of three online vignettes asking participants to imagine they had received an abnormal FOBt result, and that they had been invited for a follow-up test. The followup test offered was either: CC (n=346), CTC (n=302) or CE (n=305). Participants were then asked how likely they were to have their allocated test or if they refused, either of the other tests. Respondents were also asked to cite possible emotional and practical barriers to follow up testing. Multivariable logistic regression models were used to investigate intentions. Results: Intention to have the test was higher in the CTC group (96.7%) compared with the CC group (91.8%; OR 2.64; 95% CI 1.22 to 5.73). CTC was considered less ‘off-putting’ (OR 0.66, 95% CI 0.47 to 0.94) and less uncomfortable compared with CC (OR 0.51, 95% CI 0.34 to 0.77). For those who did not intend to have the test they were offered, CE (39.7%) or no investigation (34.5%) was preferable to CC (8.6%) or CTC (17.2%). Conclusions: Alternative tests have the potential to increase attendance at diagnostic follow-up appointments.

Type: Article
Title: Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2019-035264
Publisher version: https://doi.org/10.1136/bmjopen-2019-035264
Language: English
Additional information: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
UCL classification: UCL
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 > 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/10106554
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