Perceived risks and benefits of surveillance colonoscopy in people undergoing surveillance for family history of colorectal cancer.

AIM: To determine perceived risks and benefits of colonoscopy surveillance among patients undergoing surveillance colonoscopy due to family history of colorectal cancer (CRC).

METHOD: We conducted a standardised phone interview of 250 randomly selected people who had undergone surveillance colonoscopy at Dunedin Hospital. We assessed perceptions of colonoscopy effectiveness, complication rates, and CRC risk.

RESULTS

We included 148 (69%) participants. Most felt well informed about surveillance (66.7%), but many wanted further information (63.2%). Most accurately estimated complication rates (discomfort: Common/Uncommon 70.3%; pain: Rare/Uncommon 58.8%; bleeding: Rare/Uncommon 72.3%; perforation: Very rare 62.8%), and benefits (mean reduction in risk of CRC 72.6% and death 76.2%). Most (55.1%) over-estimated their CRC risk. 13.5% thought perforation never occurred, and 12.8% thought colonoscopy either completely prevented, or had no effect on risk of developing or dying from CRC. Patients giving unrealistic estimates had similar demographics and clinical variables to the wider cohort.

CONCLUSION

Our results suggest current surveillance education adequately communicates risks and benefits to most patients. A minority have unrealistic views and further education may be indicated.