AGA Family of Websites:

Patients aren’t always offered the CRC screening method they want

While colonoscopy is the top performed screening test, most respondents prefer the annual FIT.
Graph of patient CRC screening test preferences
Graph of patient CRC screening test preferences

In light of the 2021 change which lowered the recommended screening age for colorectal cancer (CRC) to 45 years old, researchers set out to better understand how people prefer to receive their screenings. One thousand people over the age of 40 were surveyed about their preferences. 

When asked about what they consider when getting screened, this is what respondents felt was most important:

  • Test type

  • Reduction in their chance of developing colorectal cancer

  • Frequency of the test

  • Chances of a complication

  • Bowel prep before the test

  • Required diet changes before the test

Type of test preferred by respondents: 

Graph of patient CRC screening test preferences

When limited only to the two tier 1–option tests – the annual FIT or a colonoscopy every 10 years – a substantial majority of the younger (69%) and older (77%) groups preferred the annual FIT.

“This finding is discordant with current CRC screening utilization where colonoscopy is the most commonly performed test, and this may partially explain our suboptimal screening rates,” the authors wrote. “Our findings suggest that screening programs should strongly consider a sequential-based strategy where FIT is offered first, and if declined then colonoscopy.”

Preferences did not differ a great deal between the age groups. In fact, the authors noted that sociodemographic, clinical characteristics and colorectal cancer screening knowledge, attitudes and beliefs were not predictive of selecting FIT or colonoscopy.

“The most important point from the clinical perspective is, when we’re talking to patients about colon cancer screening, make sure to give them a choice,” advised one of the study researchers, Christopher Almario, MD. “We just can’t look at someone’s chart, their clinical characteristics or demographics, and predict what tests they would prefer. We need to ask them. We need to present them with the options, go over the pros and cons of colonoscopy, the pros and cons of the stool test and ask the patient what they would prefer to do.”

This study was published in Clinical Gastroenterology and Hepatology. Read more about the findings in GI & Hepatology News, AGA’s newspaper.

AGA Clinical Guidance
Evidence-based recommendations.

AGA clinical guidance

Find the latest evidence-based recommendations for treating your patients.