Professor of Medicine and Chief of Gastroenterology Eastern Virginia Medical School Norfolk, VA
David A. Johnson, MD, MACG1, Kanetha Wilson, PhD2, Katie S. Lucero, MS, PhD3, John M. Maeglin, MBA4, Shari Dermer, PhD2, Doug Rex, MD, MACG5; 1Eastern Virginia Medical School, Norfolk, VA; 2Medscape Education, New York, NY; 3Medscape Education, New York City, NY; 4Medscape, LLC, Deerfield, IL; 5Indiana University Hospital, Indianapolis, IN
Introduction: Compliance with colorectal cancer (CRC) screening is dependent on patient’s perceptions and care provider’s recommendations. Characterizing the patient’s decision-parameters regarding CRC screening and predictors of getting a colonoscopy has not been well studied. This study addressed both of these aspects of CRC screening from the patient perspective. Methods: WebMD conducted a consumer survey from May 14 to May 26, 2020. Data were collected anonymously via pop-up from the WebMD page. The study was exempt from institutional review board approval. Respondents were from the United States and were 50 years of age or older. They must have had a CRC screening recommended to them previously. 238 consumers responded; data were used for 233 who had complete responses. Descriptive statistics were calculated, and logistic regression examined significant predictors of getting any CRC screening or a colonoscopy. Results: 69% selected colonoscopy as their CRC screening (Table 1). 15% of participants reported that they discussed multiple options with providers, and only 36% of those got a colonoscopy (Table 2). Participants who discussed multiple tests with their providers had significantly lower odds of getting a colonoscopy (Table 3). Patients who did not discuss multiple options were over 7 times more likely to get a colonoscopy. Patients whose providers recommended a colonoscopy had significant higher odds (3 times as likely to get) of having a CRC screening performed. Discussion: Patient perception of CRC screening is weighted towards detection of cancers and polyps, yet only 69% chose colonoscopy. Notably, patient expressed desire for polyp detection paradoxically was not associated with getting colonoscopy. Although 95% selected detection of precancerous polyps or detection of both cancer and polyps as an important feature of their screening, 30% ultimately didn’t get a colonoscopy. Presenting multiple options when discussing CRC screening may inhibit patient selection of colonoscopy screening. Better understanding of patient’s perspectives for CRC screening identifies areas for patient directed education as well as care providers to direct these conversations. Limitations include the use of a convenience sample, and thereby, data represent those who use the internet to find health information at WebMD.com and are not representative of all races and ethnicities or ages over 50.
Table 1. Descriptive Characteristics for Patient Sample
Table 2. CRC Screening Test Selection for Those Who Discussed Multiple Options
Table 3. Logistic Regression Results for Colonoscopy as Last CRC Screening Method
Disclosures: David Johnson: CEGX – Consultant. CRH MEDICAL – Advisory Committee/Board Member. HYGIeaCare – Advisory Committee/Board Member. ironwood – Consultant. MEDSCAPE – Advisory Committee/Board Member. Kanetha Wilson indicated no relevant financial relationships. Katie Lucero indicated no relevant financial relationships. John Maeglin indicated no relevant financial relationships. Shari Dermer indicated no relevant financial relationships. Doug Rex: Aries Pharmaceuticals – Consultant. Boston Scientific – Consultant. Medicators – Grant/Research Support. Norgine – Consultant. Olympus Corp. – Consultant, Grant/Research Support. Satisfai Health – Stockholder/Ownership Interest (excluding diversified mutual funds). Sebala Pharmaceuticals – Consultant, Grant/Research Support.