TY - JOUR

T1 - Public preferences for using quantitative faecal immunochemical test versus colonoscopy as diagnostic test for colorectal cancer

T2 - evidence from an online survey

AU - von Wagner, Christian

AU - Verstraete, Wouter

AU - Hirst, Yasemin

AU - Nicholson, Brian D

AU - Stoffel, Sandro T

AU - Laszlo, Helga

N1 - Copyright © 2020, The Authors.

PY - 2020/4/30

Y1 - 2020/4/30

N2 - BACKGROUND: There has been interest in using the non-invasive, home-based quantitative faecal immunochemical test (FIT) to rule out colorectal cancer (CRC) in high-risk symptomatic patients.AIM: To elicit public preferences for FIT versus colonoscopy (CC) and its delivery in primary care.DESIGN & SETTING: A cross-sectional online survey in England.METHOD: A total of 1057 adults (without CRC symptoms and diagnosis) aged 40-59 years were invited from an English online survey panel. Responders were asked to imagine they had been experiencing CRC symptoms that would qualify them for a diagnostic test. Participants were presented with choices between CC and FIT in ascending order of number of CRCs missed by FIT (from 1-10%). It was measured at what number of missed CRCs responders preferred CC over FIT.RESULTS: While 150 participants did not want either of the tests when both missed 1% CRCs, the majority (n = 741, 70.0%) preferred FIT to CC at that level of accuracy. However, this preference reduced to 427 (40.4%) when FIT missed one additional cancer. Women were more likely to tolerate missing CRC when using FIT. Having lower numeracy and perceiving a higher level of risk meant participants were less likely to tolerate a false negative test. Most of those who chose FIT preferred to return it by mail (62.2%), to be informed about normal test results by letter (42.1%), and about abnormal test results face to face (32.5%).CONCLUSION: While the majority of participants preferred FIT over CC when both tests had the same sensitivity, tolerance for missed CRCs was low.

AB - BACKGROUND: There has been interest in using the non-invasive, home-based quantitative faecal immunochemical test (FIT) to rule out colorectal cancer (CRC) in high-risk symptomatic patients.AIM: To elicit public preferences for FIT versus colonoscopy (CC) and its delivery in primary care.DESIGN & SETTING: A cross-sectional online survey in England.METHOD: A total of 1057 adults (without CRC symptoms and diagnosis) aged 40-59 years were invited from an English online survey panel. Responders were asked to imagine they had been experiencing CRC symptoms that would qualify them for a diagnostic test. Participants were presented with choices between CC and FIT in ascending order of number of CRCs missed by FIT (from 1-10%). It was measured at what number of missed CRCs responders preferred CC over FIT.RESULTS: While 150 participants did not want either of the tests when both missed 1% CRCs, the majority (n = 741, 70.0%) preferred FIT to CC at that level of accuracy. However, this preference reduced to 427 (40.4%) when FIT missed one additional cancer. Women were more likely to tolerate missing CRC when using FIT. Having lower numeracy and perceiving a higher level of risk meant participants were less likely to tolerate a false negative test. Most of those who chose FIT preferred to return it by mail (62.2%), to be informed about normal test results by letter (42.1%), and about abnormal test results face to face (32.5%).CONCLUSION: While the majority of participants preferred FIT over CC when both tests had the same sensitivity, tolerance for missed CRCs was low.

KW - Choice experiment

KW - Colorectal neoplasms

KW - Diagnostic tests

KW - Preference elicitation

KW - Primary health care

KW - Surveys and questionnaires

U2 - 10.3399/bjgpopen20X101007

DO - 10.3399/bjgpopen20X101007

M3 - Journal article

C2 - 32019773

VL - 4

JO - BJGP Open

JF - BJGP Open

SN - 2398-3795

IS - 1

M1 - bjgpopen20X101007

ER -