Screening status as a determinant of choice of colorectal cancer screening method: an informed population-based survey

José Luis Sandoval, Allan Relecom, Cyril Ducros, Jean-Luc Bulliard, Beatrice Arzel, Idris Guessous.
Screening Status as a Determinant of Choice of Colorectal Cancer Screening Method: A Population-Based Informed SurveyGastrointestinal Tumors, April 2021, doi: 10.1159/000512954.
Abstract

Objectives: The stool blood test is a non-invasive alternative to colonoscopy for colorectal cancer (CRC) screening. This method is preferred by a significant proportion of individuals. However, the determinants influencing participants' choice of screening method, in particular up-to-date screening status, remain less well studied. We sought to determine whether up-to-date screening status was associated with the choice of a stool blood test rather than colonoscopy.

Setting: Participants in the Health Bus population-based cross-sectional study in Geneva, Switzerland - aged 50 to 69.

Design: Cross-sectional study using mailed questionnaires, asking for the chosen CRC screening method after providing information on the advantages and disadvantages of the two screening methods. We used multivariate logistic regression models to determine the association between up-to-date CRC screening status and choice of fecal occult blood test.

We included 1,227 participants. Thirty-eight percent of participants did not have up-to-date CRC screening. Overall, in terms of choice of screening method, colonoscopy (54.9%) was preferred to fecal occult blood testing (45.1%) (p < 0.001). However, the choice of screening method differed between people with up-to-date CRC screening (65.6% colonoscopy and 34.4% fecal occult blood test) and those without up-to-date screening (36.5% colonoscopy and 63.5% fecal occult blood test). Not having up-to-date CRC screening was associated with a higher likelihood of choosing fecal occult blood testing as a screening method (odds ratio = 2.6 [1.9; 3.7], p < 0.001) after adjustment for the confounding factors mentioned above.

Conclusions: Not having up-to-date screening was independently associated with fecal blood testing as the preferred method for CRC screening. Offering this method to the sub-population concerned, in a context of shared decision making between doctor and patient, could potentially increase uptake of screening in settings where it is already high.

Link to the article in English