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

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 parti...

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Main Authors: Christian von Wagner, Sandro Tiziano Stoffel, Aradhna Kaushal, Robert Kerrison
Format: Article
Language:English
Published: BMJ Publishing Group 2020-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/7/e035264.full
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author Christian von Wagner
Sandro Tiziano Stoffel
Aradhna Kaushal
Robert Kerrison
author_facet Christian von Wagner
Sandro Tiziano Stoffel
Aradhna Kaushal
Robert Kerrison
author_sort Christian von Wagner
collection DOAJ
description 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 follow-up 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.
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spelling doaj-art-30b61736b98744c88e2cdfe7dafefe062024-12-04T10:45:09ZengBMJ Publishing GroupBMJ Open2044-60552020-07-0110710.1136/bmjopen-2019-035264Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette studyChristian von Wagner0Sandro Tiziano Stoffel1Aradhna Kaushal2Robert Kerrison3Health Behaviour Research Centre, University College London, London, UKResearch Department of Behavioural Science and Health, University College London, London, UK2 Behavioural Science and Health, University College London, London, UKDepartment of Behavioural Science & Health, University College London, London, UKObjectives 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 follow-up 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.https://bmjopen.bmj.com/content/10/7/e035264.full
spellingShingle Christian von Wagner
Sandro Tiziano Stoffel
Aradhna Kaushal
Robert Kerrison
Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study
BMJ Open
title Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study
title_full Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study
title_fullStr Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study
title_full_unstemmed Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study
title_short Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study
title_sort preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results a hypothetical vignette study
url https://bmjopen.bmj.com/content/10/7/e035264.full
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