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1 Department of Intestinal Imaging, Intestinal Imaging Centre, Level 4V, St.
Mark's Hospital, Watford Rd., Northwick Park, London HA1 3UJ, United
Kingdom.
2 Cancer Research UK Colorectal Cancer Unit, St. Mark's Hospital, Northwick
Park, London HA1 3UJ, United Kingdom.
3 Wolfson Institute of Endoscopy, St. Mark's Hospital, Northwick Park, London
HA1 3UJ, United Kingdom.
OBJECTIVE. The purpose of this study was to compare patient acceptance of multidetector CT colonography, total colonoscopy, flexible sigmoidoscopy, and double-contrast barium enema to ascertain any overall preference.
SUBJECTS AND METHODS. One hundred sixty-eight patients underwent CT colonography followed by either flexible sigmoidoscopy (n = 59) or colonoscopy (n = 109). A 25-point questionnaire with principal components relating to satisfaction, worry, and physical discomfort was administered after CT colonography and after endoscopy, and a follow-up questionnaire was administered 1 week after the procedures. Questionnaires were also completed by 140 patients undergoing double-contrast barium enema examinations. Responses were compared using Wilcoxon's matched pairs test and the Mann-Whitney test.
RESULTS. Overall satisfaction was greater with colonoscopy (p = 0.01), but CT colonography caused less discomfort (p = 0.002), was better tolerated (p = 0.005), and was the preferred follow-up investigation of those expressing a preference (p = 0.003). Compared with flexible sigmoidoscopy, CT colonography caused less pain (p = 0.004), was more acceptable (p = 0.04), and was preferred as the follow-up investigation (p < 0.001). Tolerance of colonoscopy was significantly less in women (p = 0.03), but such was not the case for CT colonography (p = 0.58). Patients undergoing CT colonography were less worried (p < 0.001), were more satisfied (p = 0.001), and suffered less discomfort (p < 0.001) than those having barium enema.
CONCLUSION. Patients' experiences with barium enema examinations were significantly worse than with any other test. Although patients were most satisfied with colonoscopy, they reported more pain during both colonoscopy and sigmoidoscopy than during CT colonography, and they also found CT more acceptable. In patients expressing a preference, CT colonography was the preferred follow-up investigation.
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