Background and study aims: Understanding patients’ experience of screening programs is crucial for service improvement.
The English Bowel Cancer Screening Programme (BCSP) aims to achieve this by sending
out questionnaires to all patients who undergo a colonoscopy following an abnormal
fecal occult blood test result. This study used the questionnaire data to report the
experiences of these patients.
Patients and methods: Data on patients who underwent colonoscopy between 2011 and 2012 were extracted from
the BCSP database. Descriptive statistics were used to summarize key questionnaire
items relating to informed choice, psychological wellbeing, physical experience, and
after-effects. Multilevel logistic regression was used to test for associations with
variables of interest: sex, age, socioeconomic status, colonoscopy results, and screening
center performance (adenoma detection rate, cecal intubation rate, proportion of colonoscopies
involving sedation).
Results: Data from 50 858 patients (79.3 % of those eligible) were analyzed. A majority reported
a positive experience on items relating to informed choice (e. g. 95.7 % felt they
understood the risks) and psychological wellbeing (e. g. 98.3 % felt they were treated
with respect). However, an appreciable proportion experienced unexpected test discomfort
(21.0 %) or pain at home (14.8 %). There were few notable demographic differences,
although women were more likely than men to experience unexpected discomfort (25.1 %
vs. 18.0 %; P < 0.01) and pain at home (18.2 % vs. 12.3 %; P < 0.01). No associations with center-level variables were apparent.
Conclusions: Colonoscopy experience was generally positive, suggesting high satisfaction with
the BCSP. Reported pain and unexpected discomfort were more negative than most other
outcomes (particularly for women); measures to improve this should be considered.
