Abstract
BACKGROUND: Individuals at increased risk of colorectal cancer (CRC) are recommended surveillance colonoscopies as a preventative measure, but timely provision of colonoscopies remains a significant hurdle. Biomarker testing has emerged as a potential strategy to mitigate excessive colonoscopy use by prioritizing procedures for those most at risk of CRC. However, the acceptability of supplementing surveillance colonoscopies with regular blood tests is unknown. AIM: To evaluate patient acceptance of a hypothetical surveillance protocol providing annual blood tests between 5-yearly colonoscopies. METHODS: Eight hundred individuals enrolled in an Australian surveillance colonoscopy program were invited to complete a survey on surveillance preferences. Ordinal logistic regression analysis was performed to assess the influence of sociodemographic, clinical, and psychological variables on participants' comfort with the surveillance protocol. RESULTS: A total of 409 (51%) individuals participated, with 346 (51% male, mean age 63 years) providing complete outcome data. Most participants (n = 250/346, 72%) reported being comfortable with the surveillance protocol. Significantly higher levels of comfort were reported by individuals with greater confidence in their ability to undergo blood testing (OR 1.26, 95% CI 1.08-1.47, p = 0.003) and those having less frequent surveillance colonoscopies (OR 1.26, 95% CI 1.01-1.58, p = 0.043). Significant associations were not observed between other variables and comfort with the surveillance protocol (p > 0.05). CONCLUSIONS: Annual blood testing between surveillance colonoscopies was highly accepted by individuals at increased risk of CRC. Offering new blood-based modalities to specific subpopulations, particularly individuals who are more comfortable with blood testing, or those having less frequent surveillance colonoscopies, could enhance overall acceptance.