Abstract
Background Research suggests physician-patient discussions about colonoscopies may be brief or absent. We sought to investigate men and women’s familiarity and experiences with colonoscopies, and perceived benefits and barriers.
Methods In the context of the multi-site CRN study “Health Literacy and Cancer Prevention” adults aged 40 to 70 were interviewed about knowledge, attitudes and experiences related to colonoscopy screening.
Results Of 1068 adults queried, 99% had heard of a colonoscopy, and 90% knew what type of cancer it tested for. 976 men and women had or intended to have a colonoscopy (accepters). The most common reasons cited for a colonoscopy were age appropriateness (59%), physician advice (56%), family history (16%), and colon-related symptoms (14%). 69 men and women had not had and did not intend to be tested (decliners). These participants cited lack of doctor recommendation (39%), age (16%), absence of family history (15%) and absence of colon-related issues (15%) as reasons. Most participants (92%) would find a normal result reassuring, and most (80%) believed having a colonoscopy would reduce their chances of dying from colon cancer. Overall, 41% would be nervous about what a colonoscopy might find and 69% agreed that having a colonoscopy is unpleasant. A statistically significant difference between accepters and decliners was found only on the latter belief, with 68% of decliners endorsing that a colonoscopy is unpleasant, compared to 82% of accepters (p<.05). There were no statistically significant differences between accepters and decliners on health literacy test scores, however those who did not know what sort of cancer a colonoscopy screened for scored lower than those who did (p<.05). Overall, 14% of participants had read or been given conflicting information about a colonoscopy; those who had were more likely to report mixed feelings about having a colonoscopy (p<.05).
Conclusions Almost all participants in this study were familiar with colonoscopy screening, and a large majority knew what type of cancer it screened for. While many participants were aware of age as a factor in screening appropriateness, not surprisingly physicians’ advice (or its absence) also appeared to be influential.
