Acceptance and Preference of Computed Tomographic Colonography and Colonoscopy: Results of a Nationwide Multicenter Comparative Questionnaire Survey in Japan

Takashi Kato; Kiyotaka Sasaki; Koichi Nagata; Michiaki Hirayama; Shungo Endo; Shoichi Horita

doi:10.23922/jarc.2023-025

Acceptance and Preference of Computed Tomographic Colonography and Colonoscopy: Results of a Nationwide Multicenter Comparative Questionnaire Survey in Japan

J Anus Rectum Colon. 2024 Apr 25;8(2):84-95. doi: 10.23922/jarc.2023-025. eCollection 2024.

Authors

Takashi Kato¹, Kiyotaka Sasaki², Koichi Nagata^{3

4}, Michiaki Hirayama⁵, Shungo Endo⁶, Shoichi Horita²

Affiliations

¹ Department of Gastroenterology, Tomakomai City Hospital, Tomakomai, Japan.
² Department of Internal Medicine, Hokkaido Gastroenterological Hospital, Sapporo, Japan.
³ Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁴ Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.
⁵ Department of Gastroenterology, Tonan Hospital, Sapporo, Japan.
⁶ Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan.

Abstract

Objectives: To investigate patient acceptance and preference for computed tomographic colonography (CTC) over colonoscopy.

Methods: Participants were recruited from a nationwide multicenter trial in Japan to assess the accuracy of CTC detection. They were scheduled to undergo colonoscopy after CTC with common bowel preparation on the same day. Some were administered sedative drugs during colonoscopy, depending on the referring clinician and participant's preferences. The participants were requested to complete a questionnaire to evaluate the acceptability of bowel preparation, examinations, and preference for future examinations.

Results: Of the 1,257 enrolled participants, 1,180 (mean age: 60.6 years; women: 43.3%) completed the questionnaire. Sedative drugs were not administered in 687 participants (unsedated colonoscopy group) and were administered intravenously during colonoscopy in 493 participants (sedated colonoscopy group). Before propensity score matching, the mean participants' age, percentages of asymptomatic participants, insufflation of gas during colonoscopy, and number of participants with a history of abdominal/pelvic operation significantly differed between the groups. After propensity score matching, 912 participants from each group were included in the analysis. In the unsedated colonoscopy group, CTC was answered as significantly easier than colonoscopy (p<0.001). Conversely, CTC was significantly more difficult than colonoscopy in the sedated colonoscopy group (p<0.001). In the unsedated colonoscopy group, 48% preferred CTC and 22% preferred colonoscopy for future examinations, whereas in the sedated colonoscopy group, 26% preferred CTC and 38% preferred colonoscopy (p<0.001).

Conclusions: CTC has superior participant acceptability compared with unsedated colonoscopy. However, our study did not observe the advantages of CTC acceptance over sedative colonoscopy.

Keywords: CT colonography; colonoscopy; patient acceptance; patient preference.