Patients' Preferences for Primary Colorectal Cancer Screening: A Survey of the National Colorectal Cancer Screening Program in Korea

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Authors: Young-Hak Cho ; Dae Ho Kim ; Jae Myung Cha ; Yoon Tae Jeen ; Jeong Seop Moon ; Jin-Oh Kim ; Sang Kil Lee ; Yu Kyung Cho ; Jong Pil Im ; Jae Young Jang ; Jeong Eun Shin ; Soon Man Yoon ; Yunho Jung ; Eun Sun Kim ; Kang Nyeong Lee ; Soo-Jeong Cho ; Yeol Kim ; Bo Young Park

MeSH: Aged ; Colonoscopy/methods ; Colonoscopy/psychology* ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/psychology* ; Early Detection of Cancer/methods ; Early Detection of Cancer/psychology* ; Female ; Humans ; Male ; Mass Screening/methods ; Mass Screening/psychology* ; Middle Aged ; Occult Blood ; Patient Preference* ; Republic of Korea ; Surveys and Questionnaires

Keywords: Colonoscopy ; Colorectal neoplasms ; Fecal occult blood test ; Preference ; Screening

Abstract: Background/Aims: The adoption of colonoscopy as a primary colorectal cancer (CRC) screening technique has been argued for in Korea, without evidence of patient preferences. This study aimed to investigate patients' preferences for the primary CRC screening test for the National Cancer Screening Program (NCSP).

Methods: Between June and August 2016, 414 individuals aged ≥50 years who participated in the NCSP were prospectively invited to complete a questionnaire regarding their preferences for the primary CRC screening test and the reasons for their selection.

Results: Among the 396 respondents who completed the questionnaire, 124 individuals (31.3%) preferred the fecal immunochemical test (FIT), whereas 272 individuals (68.7%) preferred colonoscopy. Elderly participants preferred the FIT (p<0.001), whereas participants with a higher education level (p=0.030), a higher income level (p=0.009), or individuals with a family member (p=0.028) or acquaintance (p=0.013) with a history of CRC preferred colonoscopy. Only 12.9% of participants had a bad experience with a previous FIT; however, 39.3% of participants had a bad experience with a previous colonoscopy.

Conclusions: Colonoscopy was preferred to FIT in a 2.2:1 ratio as the primary CRC screening test for the NCSP. Patients' preference for colonoscopy should be considered for the NCSP in Korea.