Nurse-led telephone triage in colorectal cancer screening: Evaluation of patient experience and clinical outcomes.

PURPOSE: To evaluate the effectiveness and patient experience of a nurse-led telephone triage service managing access to second-level colorectal cancer (CRC) screening, and to explore the relationship between subjective satisfaction and objective clinical outcomes.

METHOD: A cross-sectional study was conducted across four endoscopy units within the Bologna Local Health Authority, Italy. Between April and July 2024, patients undergoing telephone triage for colonoscopy (following a positive Faecal Immunochemical Test [FIT] or surveillance) were consecutively recruited. Patient experience was assessed via a structured telephone interview, while clinical outcomes (colonoscopy participation, Boston Bowel Preparation Scale, and examination completeness) were retrieved from the screening database.

RESULTS

Among 355 participants, overall satisfaction was high (99.2%), accompanied by 93.0% colonoscopy participation and 94.8% adequate bowel preparation. However, satisfaction was comparatively lower regarding bowel preparation information (72.4%) and appointment management (81.6%). No statistically significant association was found between patient-reported satisfaction and objective clinical outcomes (bowel preparation quality and examination completeness) (all p > 0.05). FIT-positive patients reported lower satisfaction levels compared to surveillance patients, and the logistics of bowel preparation kit collection emerged as a critical barrier.

CONCLUSION

Nurse-led telephone triage proves to be a robust standard in the CRC screening pathway, balancing operational efficiency with high patient acceptance and clinical quality. The observed dissociation between satisfaction and preparation adequacy underscores the complex interplay between subjective perception and behavioural action, rather than a failure of communication. Future optimization requires standardizing best practices, resolving logistical barriers, and implementing tailored, multimodal education, ensuring a pathway that is truly remote and patient-centred.