Patient experience and preferences toward colon cancer screening: a comparison of virtual colonoscopy and conventional colonoscopy

Background. Virtual colonoscopy has excellent sensitivity for the detection of cancer and polyps greater than 1 cm in diameter. For virtual colonoscop y to succeed as a screening test for colorectal neoplasia, it must be well tolerated and accepted by patients. Patients' experiences with virtual colo noscopy and conventional colonoscopy were assessed and compared. Methods: Patients referred to the GI clinic for colonoscopy for any indicat ion were recruited to undergo virtual colonoscopy before conventional colon oscopy. Patients were asked to complete a questionnaire twice: after virtua l colonoscopy and after completing both tests. Three variables, overall pai n, discomfort, and lack of respect, were assessed by using a 7-point Liken scale with higher scores denoting a worse experience. Patients' preferences for virtual colonoscopy versus conventional colonoscopy were determined wi th a time tradeoff technique. To verify response stability, patients were a sked to return an additional questionnaire by mail at 24 hours. Results: Two hundred ninety-five patients completed the questionnaire immed iately after the procedures, and 83 patients completed the questionnaire at 24 hours. At both 0 and 24 hours, patients reported more pain, discomfort, and less respect after virtual colonoscopy than conventional colonoscopy ( p < 0.01). The overall agreement (Kappa statistic) between times 0 and 24 h ours was fair. Patients reported that they preferred conventional colonosco py and would wait longer for conventional colonoscopy (mean = 4.9 weeks) th an undergo a virtual colonoscopy (p < 0.01). Conclusions: Patients tolerate both virtual colonoscopy and conventional co lonoscopy, although they report more pain, discomfort, and less respect und ergoing virtual colonoscopy. Efforts to improve patient experience during v irtual colonoscopy need to be investigated.