Introduction Bowel cancer screening (BCSP) began in England in 2006. Patients found to have a positive faecal occult blood test undergo a colonoscopy performed by an accredited colonoscopist. In contrast to “symptomatic” patients referred for a colonoscopy, those within BCSP first have a 45-min pre-assessment appointment with a specialist screening practioner (SSP). The same SSP then follows the patient throughout their episode, attending the colonoscopy and personally following up the patient. This is in contrast to the more fragmented care routinely offered to patients. The aim of this study was to assess whether there was any difference in patient satisfaction between these two patient groups.
Methods Between Jan and March2009, 100 consecutive patients (50 routine diagnostic and 50 BCSP colonoscopies), were given a questionnaire to complete at home following their procedure. The questionnaire addressed three domains – pre, during and post procedure experiences. Fisher's exact test was used to compare the satisfaction responses between two groups.
Results The overall response rate was 76/100, 76% (42 in BCSP and 34 diagnostic group). Although there was no difference in the overall level of satisfaction between the two groups, 4/30 (13%) of patients having diagnostic colonoscopy reported not having been given adequate explanation of the risk compared to no patients within BCSP (p=0.03). 6/24 (25%) of patients in the routine colonoscopy group felt they needed more sedation compared to 0/30 (0%) of patients in the BCSP group (p=0.005). Similarly, the level of discomfort reported was higher in diagnostic group compared to BCSP, with 14/33 (42%) diagnostic patients reporting a “quite or extremely uncomfortable procedure” compared to only 4/41 (10%) in the BCSP, p=0.004. 39/40 (97%) of patients in the BCSP felt there were given adequate explanation of findings compared to 21/32 (64%) of those having routine colonoscopy, p<0.001.
Conclusion There are differences in satisfaction between BCSP patients and those having routine diagnostic colonoscopy, particularly relating to degree of comfort during and explanation given after the procedure. The reasons for this maybe multifactorial (presence of SSPs, accredited colonoscopists, asymptomatic vs symptomatic patients) however improvements in pre and post procedural care should be addressed to ensure an equal quality of service is offered to all patients.
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