Colorectal cancer is a significant cause of cancer-related deaths in the United States, but many eligible adults do not undergo regular screening.
Colonoscopy, a procedure often recommended by healthcare providers, can be a barrier to screening.
A recent study reveals that when given a choice, a majority of individuals with an average risk of colorectal cancer prefer stool-based screening tests over colonoscopy, highlighting the importance of patient preferences in increasing screening rates.
Challenges in Colorectal Cancer Screening
Colorectal cancer screening is underutilized, especially among disadvantaged populations, racial/ethnic minorities, and certain age groups.
To address this issue, the U.S. Preventive Services Task Force (USPSTF) recommends various screening methods, including colonoscopy and stool-based tests, for adults aged 50 to 75.
The recent draft guideline suggests lowering the age for screening initiation to 45.
Preference for Stool-Based Tests
The study, led by Xuan Zhu, Ph.D., assessed patient preferences for colorectal cancer screening.
The survey included descriptions of three screening methods: colonoscopy, multitarget stool DNA (mt-sDNA) test, and fecal immunochemical test (FIT/FOBT). The survey involved a nationally representative sample of adults aged 45 to 75.
When given a choice, 66% of respondents preferred mt-sDNA over colonoscopy, and 61% preferred FIT/FOBT over colonoscopy.
Among stool-based options, 67% indicated a preference for mt-sDNA over FIT/FOBT.
Older adults (65 to 75 years) were more likely to prefer colonoscopy, while younger age groups (45 to 54 years) preferred stool-based tests.
Non-Hispanic white individuals had a higher preference for mt-sDNA over colonoscopy compared to non-Hispanic Black and Hispanic individuals.
Uninsured respondents were more likely to prefer less expensive stool-based tests over colonoscopy.
Awareness of stool-based tests was lower (60%) compared to colonoscopy (90%).
Implications and Recommendations
The study underscores the importance of patient education about available screening options and the need to consider patient preferences in shared decision-making discussions.
Patients are more likely to complete the screening test they prefer, highlighting the significance of tailoring screening approaches to individual needs and values.
Providing navigation support, especially for transitioning from stool-based tests to colonoscopy if needed, can improve screening completion and adherence.
Study Limitations
The study’s observational design does not establish causal relationships. It relied on self-reported data rather than objective measures.
The scope was limited to the three most commonly recommended colorectal cancer screening tests.
Understanding patient preferences and addressing barriers to screening are crucial steps in increasing colorectal cancer screening rates.
Stool-based tests, when offered as options, can be preferred by many individuals, ultimately contributing to more effective cancer prevention and early detection efforts.
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The research findings can be found in Cancer Prevention Research.
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