PURPOSE: To use a randomized design to compare patients' short- and longer-term experiences after computed tomographic (CT) colonography or colonoscopy. MATERIALS AND METHODS: After ethical approval, the trial was registered. Patients gave written informed consent. Five hundred forty-seven patients with symptoms suggestive of colorectal cancer who had been randomly assigned at a ratio of 2:1 to undergo either colonoscopy (n = 362) or CT colonography (n = 185) received a validated questionnaire to assess immediate test experience (including satisfaction, worry, discomfort, adverse effects) and a 3-month questionnaire to assess psychologic outcomes (including satisfaction with result dissemination and reassurance). Data were analyzed by using Mann-Whitney U, Kruskal-Wallis, and χ(2) test statistics. RESULTS: Patients undergoing colonoscopy were less satisfied than those undergoing CT colonography (median score of 61 and interquartile range [IQR] of 55-67 vs median score of 64 and IQR of 58-70, respectively; P = .008) and significantly more worried (median score of 16 [IQR, 12-21] vs 15 [IQR, 9-19], P = .007); they also experienced more physical discomfort (median score of 39 [IQR, 29-51] vs 35 [IQR, 24-44]) and more adverse events (82 of 246 vs 28 of 122 reported feeling faint or dizzy, P = .039). However, at 3 months, they were more satisfied with how results were received (median score of 4 [IQR, 3-4] vs 3 [IQR, 3-3], P < .0005) and less likely to require follow-up colonic investigations (17 of 230 vs 37 of 107, P < .0005). No differences were observed between the tests regarding 3-month psychologic consequences of the diagnostic episode, except for a trend toward a difference (P = .050) in negative affect (unpleasant emotions such as distress), with patients undergoing CT colonography reporting less intense negative affect. CONCLUSION: CT colonography has superior patient acceptability compared with colonoscopy in the short term, but colonoscopy offers some benefits to patients that become apparent after longer-term follow-up. The respective advantages of each test should be balanced when referring symptomatic patients.
PURPOSE: To use a randomized design to compare patients' short- and longer-term experiences after computed tomographic (CT) colonography or colonoscopy. MATERIALS AND METHODS: After ethical approval, the trial was registered. Patients gave written informed consent. Five hundred forty-seven patients with symptoms suggestive of colorectal cancer who had been randomly assigned at a ratio of 2:1 to undergo either colonoscopy (n = 362) or CT colonography (n = 185) received a validated questionnaire to assess immediate test experience (including satisfaction, worry, discomfort, adverse effects) and a 3-month questionnaire to assess psychologic outcomes (including satisfaction with result dissemination and reassurance). Data were analyzed by using Mann-Whitney U, Kruskal-Wallis, and χ(2) test statistics. RESULTS: Patients undergoing colonoscopy were less satisfied than those undergoing CT colonography (median score of 61 and interquartile range [IQR] of 55-67 vs median score of 64 and IQR of 58-70, respectively; P = .008) and significantly more worried (median score of 16 [IQR, 12-21] vs 15 [IQR, 9-19], P = .007); they also experienced more physical discomfort (median score of 39 [IQR, 29-51] vs 35 [IQR, 24-44]) and more adverse events (82 of 246 vs 28 of 122 reported feeling faint or dizzy, P = .039). However, at 3 months, they were more satisfied with how results were received (median score of 4 [IQR, 3-4] vs 3 [IQR, 3-3], P < .0005) and less likely to require follow-up colonic investigations (17 of 230 vs 37 of 107, P < .0005). No differences were observed between the tests regarding 3-month psychologic consequences of the diagnostic episode, except for a trend toward a difference (P = .050) in negative affect (unpleasant emotions such as distress), with patients undergoing CT colonography reporting less intense negative affect. CONCLUSION: CT colonography has superior patient acceptability compared with colonoscopy in the short term, but colonoscopy offers some benefits to patients that become apparent after longer-term follow-up. The respective advantages of each test should be balanced when referring symptomatic patients.
Authors: A Venara; C Ridereau-Zins; L Toque; E Cesbron; S Michalak; E Lermite; C Aube; A Hamy Journal: Int J Colorectal Dis Date: 2015-02-27 Impact factor: 2.571
Authors: Kevin J Monahan; Michael M Davies; Muti Abulafi; Ayan Banerjea; Brian D Nicholson; Ramesh Arasaradnam; Neil Barker; Sally Benton; Richard Booth; David Burling; Rachel Victoria Carten; Nigel D'Souza; James Edward East; Jos Kleijnen; Michael Machesney; Maria Pettman; Jenny Pipe; Lance Saker; Linda Sharp; James Stephenson; Robert Jc Steele Journal: Gut Date: 2022-07-12 Impact factor: 31.793
Authors: Gemma Binefa; Francisco Rodríguez-Moranta; Alex Teule; Manuel Medina-Hayas Journal: World J Gastroenterol Date: 2014-06-14 Impact factor: 5.742
Authors: Marcelo Longo Kierszenbaum; Augusto Castelli von Atzingen; Dario Ariel Tiferes; Marcos Vinicius Alvim; Gaspar de Jesus Lopes Filho; Délcio Matos; Giuseppe D'Ippolito Journal: Radiol Bras Date: 2014 May-Jun
Authors: Thierry N Boellaard; Marije P van der Paardt; Markus W Hollmann; Susanne Eberl; Jan Peringa; Lex J Schouten; Giedre Kavaliauskiene; Jurgen H Runge; Jeroen A W Tielbeek; Jaap Stoker Journal: BMC Gastroenterol Date: 2013-05-25 Impact factor: 3.067
Authors: Thomas Hampshire; Holger R Roth; Emma Helbren; Andrew Plumb; Darren Boone; Greg Slabaugh; Steve Halligan; David J Hawkes Journal: Med Image Anal Date: 2013-04-27 Impact factor: 8.545