Patient Acceptability and Psychologic Consequences of CT Colonography Compared with Those of Colonoscopy: Results from a Multicenter Randomized Controlled Trial of Symptomatic Patients

Abstract

For the SIGGAR Investigators Purpose:To use a randomized design to compare patients' short-and longer-term experiences after computed tomographic (CT) colonography or colonoscopy. Materials and Methods:After ethical approval, the trial was registered. Patients gave written informed consent. Five hundred forty-seven patients with symptoms suggestive of colorectal cancer who had been randomly assigned at a ratio of 2:1 to undergo either colonoscopy (n = 362) or CT colonography (n = 185) received a validated questionnaire to assess immediate test experience (including satisfaction, worry, discomfort, adverse effects) and a 3-month questionnaire to assess psychologic outcomes (including satisfaction with result dissemination and reassurance). Data were analyzed by using Mann-Whitney U, Kruskal-Wallis, and x 2 test statistics. Results:Patients undergoing colonoscopy were less satisfied than those undergoing CT colonography (median score of 61 and interquartile range [IQR] of 55-67 vs median score of 64 and IQR of 58-70, respectively; P = .008) and significantly more worried (median score of 16 [IQR,[12][13][14][15][16][17][18][19][20][21] vs 15 [IQR,[9][10][11][12][13][14][15][16][17][18][19], P = .007); they also experienced more physical discomfort (median score of 39 [IQR, vs 35 [IQR,) and more adverse events (82 of 246 vs 28 of 122 reported feeling faint or dizzy, P = .039). However, at 3 months, they were more satisfied with how results were received (median score of 4 [IQR,[3][4], P , .0005) and less likely to require follow-up colonic investigations (17 of 230 vs 37 of 107, P , .0005). No differences were observed between the tests regarding 3-month psychologic consequences of the diagnostic episode, except for a trend toward a difference (P = .050) in negative affect (unpleasant emotions such as distress), with patients undergoing CT colonography reporting less intense negative affect.

CT colonography for investigation of patients with symptoms potentially suggestive of colorectal cancer: a review of the UK SIGGAR trials

“…They were also significantly more likely to experience a range of post-procedural side effects. Patients undergoing colonoscopy were significantly less satisfied and more worried than those undergoing CTC [27] and also experienced more physical discomfort and adverse events. However, at 3 months, they were more satisfied with how their results were received.…”

Detection of Extracolonic Pathologic Findings with CT Colonography: A Discrete Choice Experiment of Perceived Benefits versus Harms

“…A research assistant mailed information and consent forms beforehand, and responders were interviewed on their appointment day. Individuals with a history of CRC or who underwent investigations for possible CRC were excluded to avoid bias (18). Additionally, harm is important because further tests precipitated by extracolonic findings are common, occurring in 7%-11% of people who are screened after CT colonography (2)(3)(4)(5)(6)(7)(8)(9).…”

Effect of listening to music and essential oil inhalation on patients undergoing screening CT colonography: A randomized controlled trial

“…Computed tomographic colonography (CTC) is regarded as a less invasive and more acceptable total colon examination compared with colonoscopy [1][2][3][4]. An additional advantage of CTC over colonoscopy is its lower complication rate [5,6].…”