Patients’ experience of screening CT colonography with reduced and full bowel preparation in a randomised trial
- 168 Downloads
To assess patients’ experience of bowel preparation and procedure for screening CT colonography with reduced (r-CTC) and full cathartic preparation (f-CTC) that showed similar detection rate for advanced neoplasia in a randomised trial.
Six hundred seventy-four subjects undergoing r-CTC and 612 undergoing f-CTC in the SAVE trial were asked to complete two pre-examination questionnaires—(1) Life Orientation Test - Revised (LOT-R) assessing optimism and (2) bowel preparation questionnaire—and a post-examination questionnaire evaluating overall experience of CTC screening test. Items were analysed with chi-square and t test separately and pooled.
LOT-R was completed by 529 (78%) of r-CTC and by 462 (75%) of f-CTC participants and bowel preparation questionnaire by 531 (79%) subjects in the r-CTC group and by 465 (76%) in the f-CTC group. Post-examination questionnaire was completed by 525 (78%) subjects in the r-CTC group and by 453 (74%) in the f-CTC group. LOT-R average score was not different between r-CTC (14.27 ± 3.66) and f-CTC (14.54 ± 3.35) (p = 0.22). In bowel preparation questionnaire, 88% of r-CTC subjects reported no preparation-related symptoms as compared to 70% of f-CTC subjects (p < 0.001). No interference of bowel preparation with daily activities was reported in 80% of subjects in the r-CTC group as compared to 53% of subjects in the f-CTC group (p < 0.001). In post-examination questionnaire, average scores for discomfort of the procedure were not significantly different between r-CTC (3.53 ± 0.04) and f-CTC (3.59 ± 0.04) groups (p = 0.84).
Reduced bowel preparation is better tolerated than full preparation for screening CT colonography.
• Reduced bowel preparation is better tolerated than full preparation for screening CT colonography.
• Procedure-related discomfort of screening CT colonography is not influenced by bowel preparation.
• Males tolerate bowel preparation and CT colonography screening procedure better than females.
KeywordsCT colonography Virtual colonoscopy Questionnaire
Full cathartic preparation CT colonography
Faecal immunochemical test
Life Orientation Test - Revised
Reduced cathartic preparation CT colonography
We acknowledge Dr. Matteo Cuccuini, Dr. Giacomo Gabbani, Dr. Giulia Grazzini, Dr. Giulia Scarpini, and Dr. Ilaria Vitali from Florence, Italy, for data collection.
The results of this study were presented at ECR 2018 (B-0521).
This study has received funding by Tuscany Region, Italy (POR CREO FESR 2007–2013 LINEA D’INTERVENTO 1.1c, grant number 009DUA000000000089835900120000000002), and by the Cassa di Risparmio di Firenze Foundation (grant number 2012.0742A2202.3931).
Compliance with ethical standards
The scientific guarantor of this publication is Professor Mario Mascalchi.
Conflict of interest
One author of this manuscript (Silvia Delsanto) declares relationships with the following company: Im3D, Turin, Italy.
All other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was obtained from all subjects in this study.
Institutional Review Board approval was obtained.
Study subjects or cohorts overlap
Socio-demographic characteristics of the SAVE trial invitees and participants, as well as participation rate and detection rate for advanced neoplasia after the first screening round, were previously reported in Sali L, Mascalchi M, Falchini M, et al Reduced and full-preparation CT colonography, fecal immunochemical test, and colonoscopy for population screening of colorectal cancer: a randomized trial. J Natl Cancer Inst 2015;108: 319.
• Randomised controlled trial
• Performed at one institution
- 1.US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC et al (2016) Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA 315:2564–2575Google Scholar
- 6.Sali L, Mascalchi M, Falchini M et al (2015) Reduced and full-preparation CT colonography, fecal immunochemical test, and colonoscopy for population screening of colorectal cancer: a randomized trial. J Natl Cancer Inst 108. https://doi.org/10.1093/jnci/djv319
- 9.Giorgi Rossi P, Camilloni L, Cogo C et al (2012) Methods to increase participation in cancer screening programmes. Epidemiol Prev 36:1–104Google Scholar
- 20.Nagata K, Okawa T, Honma A, Endo S, Kudo SE, Yoshida H (2009) Full-laxative versus minimum-laxative fecal-tagging CT colonography using 64-detector row CT: prospective blinded comparison of diagnostic performance, tagging quality, and patient acceptance. Acad Radiol 16:780–789Google Scholar
- 22.Iafrate F, Iannitti M, Ciolina M, Baldassari P, Pichi A, Laghi A (2015) Bowel cleansing before CT colonography: comparison between two minimal-preparation regimens. Eur Radiol 25:203–210Google Scholar
- 34.Ghanouni A, Halligan S, Plumb A, Boone D, Wardle J, von Wagner C (2014) Non- or full-laxative CT colonography vs. endoscopic tests for colorectal cancer screening: a randomised survey comparing public perceptions and intentions to undergo testing. Eur Radiol 24:1477–1486Google Scholar