Research Article: Patients’ experience of using colonoscopy as a diagnostic test after a positive FOBT/FIT: a systematic review of the quantitative literature
Abstract:
Objectives Faecal occult blood testing (FOBT) and faecal immunochemical testing (FIT) are among the most used screening modalities for colorectal cancer (CRC). Colonoscopy is also widely used as a screening and diagnostic test for adults with a positive FOBT/FIT. Patient experience of colonoscopy is an important component for most CRC screening programmes. Individuals with negative experiences are less likely to engage with colonoscopy in the future and can deter others from attending colonoscopy when invited. This review synthesised data on patient experience with colonoscopy, following a positive result, to provide insights into how to improve patient experience within the English Bowel Cancer Screening Programme. Methods MEDLINE, EMBASE and PsycINFO were searched for quantitative questionnaire studies evaluating patient-reported experience with colonoscopy, following a positive screening FOB/FIT result. The search was limited to studies published between 2000 and 2021 (ie, when the first FOBT/FIT screening programmes for CRC were introduced). Data-driven and narrative summary techniques were used to summarise the literature. Results In total, six studies from the UK (n=4), Spain (n=1) and the Netherlands (n=1) were included in the review (total participants: 152 329; response rate: 68.0–79.3%). Patient experiences were categorised into three ‘stages’: ‘pre-colonoscopy’, ‘during the test’ and ‘post-colonoscopy’. Overall, patients reported a positive experience in all six studies. Bowel preparation was the most frequently endorsed issue experienced pre-test (experienced by 10.0–41.0% of individuals, across all studies), pain and discomfort for during the test (experienced by 10.0–21.0% of participants) and abdominal pain and discomfort after the test (these were experienced by 14.8–22% of patients). Conclusion This review highlighted that patient-reported experiences associated with colonoscopy were generally positive. To improve the colonoscopy experience, bowel screening centres should investigate means to: make bowel preparation more acceptable, make colonoscopy less painful and reduce post-colonoscopy symptoms.
Introduction:
The global incidence rate of colorectal cancer (CRC) is predicted to grow by 60%, with more than 2.2?million new cases and 1.1?million additional deaths by 2030. 1 Screening aims to discover signs of cancer early, before the appearance of any symptoms, when treatment is less invasive and more effective. Screening can also decrease CRC mortality by preventing cancer progression by removing precancerous polyps. 2 There is significant evidence to support the implementation of organised CRC screening programmes. 3 As…
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