The online version of this article (doi:10.1186/1471-230X-14-183) contains supplementary material, which is available to authorized users.
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.
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.
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.
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.
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.
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.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F: GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: [ http://globocan.iarc.fr] accessed on 13/05/2014
Brenner H, Chang-Claude J, Jansen L, Knebel P, Stock C, Hoffmeister M: Reduced risk of colorectal cancer up to 10 y after screening, surveillance, or diagnostic colonoscopy. Gastroenterology. 2013, doi:10.1053/j.gastro.2013.09.001
U.S. Preventive Services Task Force: Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. AHRQ Publication 08-05124-EF-3, October 2008. [ http://www.uspreventiveservicestaskforce.org/uspstf08/colocancer/colors.htm]
Joseph DA, King JB, Miller JW, Richardson LC: Prevalence of colorectal cancer screening among adults–behavioral risk factor surveillance system, United States, 2010. MMWR Morb Mortal Wkly Rep. 2012, 61 (Suppl): 51-56.
OECD: Screening, survival and mortality for colorectal cancer. Health at a Glance: Europe 2012. 2012, OECD Publishing, [ http://dx.doi.org/10.1787/9789264183896-48-en]
Adler A, Roll S, Marowski B, Drossel R, Rehs HU, Willich SN, Riese J, Wiedenmann B, Rösch T, Berlin Private-Practice Gastroenterology Working Group: Appropriateness of colonoscopy in the era of colorectal cancer screening: a prospective, multicenter study in a private-practice setting (Berlin Colonoscopy Project 1, BECOP 1). Dis Colon Rectum. 2007, 50: 1628-1638. 10.1007/s10350-007-9029-y. CrossRefPubMed
Adler A, Wegscheider K, Lieberman D, Aminalai A, Aschenbeck J, Drossel R, Mayr M, Mroß M, Scheel M, Schröder A, Gerber K, Stange G, Roll S, Gauger U, Wiedenmann B, Altenhofen L, Rosch T: Factors determining the quality of screening colonoscopy: a prospective study on adenoma detection rates, from 12,134 examinations (Berlin colonoscopy project 3, BECOP-3). Gut. 2013, 62 (2): 236-241. 10.1136/gutjnl-2011-300167. CrossRefPubMed
Inadomi J, Vijan S, Janz NK, Fagerlin A, Thomas JP, Lin YV, Munoz R, Lau C, Somsouk M, El-Nachef N, Hayward RA: Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med. 2012, 172 (7): 575-582. 10.1001/archinternmed.2012.332. CrossRefPubMedPubMedCentral
Weiss G, Rösch T: Potential of a new blood test for colorectal cancer screening – the septin 9 gene biomarker. Eur Oncol. 2010, 6 (1): 51-54.
Tóth K, Sipos F, Kalmár A, Patai AV, Wichmann B, Stoehr R, Golcher H, Schellerer V, Tulassay Z, Molnár B: Detection of methylated SEPT9 in plasma is a reliable screening method for both left- and right-sided colon cancers. PLoS One. 2012, 7 (9): e46000-10.1371/journal.pone.0046000. doi:10.1371/journal.pone.0046000. Epub 2012 Sep 25 CrossRefPubMedPubMedCentral
German Census 2011 Data. [ https://ergebnisse.zensus2011.de/?locale=en#] accessed Sept. 15 th, 2014
Moiel D, Thompson J: Early detection of colon cancer-the Kaiser Permanente northwest 30-year history: how do we measure success? Is it the test, the number of tests, the stage, or the percentage of screen-detected patients?. Perm J. 2011, 4: 30-38.
Benning TM, Dellaert BGC, Dirksen CD, Severens JL: Preferences for potential innovations in non-invasive colorectal cancer screening: a labeled discrete choice experiment for a Dutch screening campaign. Acta Oncol. 2014, doi:10.3109/0284186X.2013.877159
- Improving compliance to colorectal cancer screening using blood and stool based tests in patients refusing screening colonoscopy in Germany
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II