A survey of individual preference for colorectal cancer screening technique

A cross-sectional survey was performed of healthy ambulatory adults in a pediatrics primary care office and neighboring church. Overall preference was ranked for each of four colorectal cancer screening modalities: Faecal Occult Blood, Fiberoptic Sigmoidoscopy, Barium Enema and Colonoscopy. Four additional domains of preference also were ranked: suspected discomfort, embarrassment, inconvenience and danger of each exam.80 surveys were analyzed, 57 of which were received from participants who had experienced none of the screening tests. Fecal Occult Blood Testing is significantly preferred over each other screening modality in overall preference and every domain of preference, among all subjects and those who had experienced none of the tests.Efforts to increase public participation in colorectal cancer screening may be more effective if undertaken in the context of public perceptions of screening choices.Screening for colorectal cancer lessens the risk of dying from that disease [1]. Knowledge of this fact has not solved all the problems related to screening. The optimal modality of screening is still the subject of debate [1-3]. More problematic is the very low participation of the general public in recommended screening [4]. In contrast to breast cancer screening, in which the Healthy People 2000 Goal of the U.S. National Institutes of Health was surpassed, at 64% participation by women over 40 years of age, only 20% of Americans over age 50 had fecal occult blood testing within the past year (This is the best estimate of actual screening, rather than diagnostic endeavors for symptoms for which endoscopy or radiologic imaging might be done.), and 34% had a sigmoidoscopy within the past 5 years [5,6] Even if screening is appropriately performed, it is far from certain that a positive screen will be followed by appropriate diagnostic testing, as has been shown in follow-up surveys of fecal occult blood testing [7].Most publication concerning colorectal cancer screen