[img_inline align=”right” src=”http://padnws01.mcmaster.ca/images/Marshall,-John.jpg” caption=”John Marshall”]Initial research shows that when it comes to screening for colon cancer, patients prefer the accuracy of a colonoscopy over other less invasive and more comfortable tests.

The SCREEN study (the Study of Colorectal Cancer Screening Using Research on Economics) is a four-year study funded by the U.S. National Cancer Institute, which began in 2004.

John Marshall, associate professor of medicine at McMaster, is an investigator with a sub-study of SCREEN, which is looking at patient preferences. Marshall says that the initial research data suggests individuals want accuracy, and are willing to undergo tests that might be embarrassing and uncomfortable to get reassurance.

The Patient Preference sub-study group will be making a presentation on their initial findings at the 29th Annual meeting of the American Society of Preventive Oncology in San Francisco on March 13.

Marshall feels that one of the reasons people might choose a colonoscopy over other screening methods is because it is all-inclusive and must be done only once a decade. Other tests, such as barium enema, sigmoidoscopy and fecal occult blood tests, are less invasive and safer. However, if they are abnormal, patients must then undergo a colonoscopy to confirm whether they have cancer and remove precancerous polyps.

“We know colorectal screening works,” says Marshall. “In the U.S., colorectal cancer screening by any of these method is encouraged and paid for. Canada doesn't have any guidelines and provinces are not endorsing screening, with the exception of Ontario, which is conducting a pilot evaluation of the fecal occult blood test, possibly because it's the only method that has been tested in big clinical trials.

“But regardless of whether it's encouraged or paid for, statistics show that many patients still do not get screened for colorectal cancer. This research will help us understand what drives people to undergo screening, and why some would prefer one test (like colonoscopy) over another. Our goal is to be able to recommend a comprehensive screening package that will work for everyone, one that takes into account accuracy, patient preference and cost. With better knowledge we can increase the uptake and success of colorectal cancer screening.”

Initial research results were obtained through a large survey of patients in Stoney Creek, Ontario, and through a series of focus groups in Hamilton and San Francisco. The Patient Preference sub-study group has launched a large internet- based survey that will target both doctors and patients in the U.S. and Canada.