S615 Patient Perceptions (and Misperceptions) of Colon Cancer Screening

Introduction: In the United States, colorectal cancer (CRC) remains the second most common cause of death related to cancer. Routine screening is recommended for early detection and can be achieved through fecal testing or colonoscopy (CSY). Adherence to CRC screening is dependent on patients’ perceptions of the benefits and effectiveness of screening methods. We conducted a survey study to gain a better understanding of patients’ 1) baseline knowledge, 2) opinions, and 3) risk tolerance surrounding screening CSYs. Methods: This single center, prospective survey study included 8 questions inquiring about lifetime risk of CRC, risks and benefits of CSY, and risk tolerance for screening CSY. We included adult patients undergoing screening or diagnostic CSYs. Patients were invited to participate in the study while in the pre-operative waiting area prior to their procedure. Results: Fifty-five patients were included in the final analysis. Demographics included median age of 55, 47% male patients, and 5% of patients >75 years old. Seventy-three percent of patients were undergoing screening CSY with the majority (88%) identified as average risk. Twenty-five percent of patients correctly recognized the lifetime risk of CRC as 1%-10% while the majority (71%) felt it was higher. Over half of patients (51%) knew that >50% of CRC could be prevented with regular screening. Sixty-nine percent of patients thought that polyps take 5 or less years to develop into cancer (median = 5 years). Eighty-two percent of patients recognized the risk of adverse outcomes with screening CSY is quite low (<1%). Thirty-five percent of patients would elect to undergo screening CSY at age 75 if their life expectancy was as low as 1-2 years; most patients (76%) would desire CSY if their life expectancy was closer to 5-10 years. Conclusion: In summary, most patients assumed substantial CRC risk reduction with regular screening; however, they overestimated the lifetime risk of CRC as well as the speed of polyp progression. Interestingly, many patients would opt to undergo screening CSY at age 75 knowing there is a small (0.05%) chance of reducing their risk for developing CRC over the next 10 years. Our results highlight opportunities for improved education in the CRC screening process; specifically, when patients near age 75 and may have limited benefit from continued surveillance. Limitations include selection bias and modest sample size. Future work will focus on expanding and diversifying the patient cohort to better inform our clinical and educational practice.