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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Gastroenterology 1/2014

Improving compliance to colorectal cancer screening using blood and stool based tests in patients refusing screening colonoscopy in Germany

Zeitschrift:
BMC Gastroenterology > Ausgabe 1/2014
Autoren:
Andreas Adler, Sebastian Geiger, Anne Keil, Harald Bias, Philipp Schatz, Theo deVos, Jens Dhein, Mathias Zimmermann, Rudolf Tauber, Bertram Wiedenmann
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-230X-14-183) contains supplementary material, which is available to authorized users.

Competing interests

PS – At the time of the study, PS was an employee of Epigenomics, a study sponsor. TdV – At the time of the study TdV was an employee of Epigenomics, a study sponsor. JD – At the time of the study JD was an employee Abbott Molecular, a study sponsor. All other authors have no competing interests. The study was funded by grants from Epigenomics AG and Abbott Molecular.

Authors’ contributions

AA – study PI, study design, drafted manuscript. SG – study design, AK – study implementation, data collection, data review. HB – study design. PS – study design, data analysis, manuscript drafting. TdV – data analysis, manuscript drafting. JD – study design. MZ – analysis of test results. RT – analysis of test results. BW – study design and approval. All authors read and approved the final manuscript.

Abstract

Background

Despite strong recommendations for colorectal cancer (CRC) screening, participation rates are low. Understanding factors that affect screening choices is essential to developing future screening strategies. Therefore, this study assessed patient willingness to use non-invasive stool or blood based screening tests after refusing colonoscopy.

Methods

Participants were recruited during regular consultations. Demographic, health, psychological and socioeconomic factors were recorded. All subjects were advised to undergo screening by colonoscopy. Subjects who refused colonoscopy were offered a choice of non-invasive tests. Subjects who selected stool testing received a collection kit and instructions; subjects who selected plasma testing had a blood draw during the office visit. Stool samples were tested with the Hb/Hp Complex Elisa test, and blood samples were tested with the Epi proColon® 2.0 test. Patients who were positive for either were advised to have a diagnostic colonoscopy.

Results

63 of 172 subjects were compliant to screening colonoscopy (37%). 106 of the 109 subjects who refused colonoscopy accepted an alternative non-invasive method (97%). 90 selected the Septin9 blood test (83%), 16 selected a stool test (15%) and 3 refused any test (3%). Reasons for blood test preference included convenience of an office draw, overall convenience and less time consuming procedure.

Conclusions

97% of subjects refusing colonoscopy accepted a non-invasive screening test of which 83% chose the Septin9 blood test. The observation that participation can be increased by offering non-invasive tests, and that a blood test is the preferred option should be validated in a prospective trial in the screening setting.
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