The offer of advanced endoscopic imaging techniques lead to higher acceptance rates for colonoscopy – A prospective study

Background: Colonoscopy requires public and professional acceptance to ensure the ongoing success of screening programs.

Aim: Prospective assessment whether patients awareness and acceptance rates to undergo screening or surveillance colonoscopy could be improved by the offer of advanced imaging techniques, including chromoendoscopy, magnification endoscopy, spectroscopy, confocal laser endomicroscopy, endocytoscopy, capsule endoscopy, CT-colonography or device-assisted enteroscopy.

Methods: Overall, 372 randomly selected patients (168 female, 204 male) were prospectively included. At baseline, a standardized questionnaire was developed. Afterwards, knowledge of advanced imaging techniques was inquired and if the patient was motivated by the specific offer of these imaging techniques to undergo colonoscopy. In the second phase, several media campaigns through press, internet, TV coverage, and information events were organized reporting about advanced imaging techniques, followed by repeat evaluation of the patients. This sequence (media campaign and patients' evaluation) was repeated every 3 months over a period of 12 months.

Results: At baseline, 64% of the patients declared, that knowledge about new endoscopic methods is completely unknown. After the evaluation period this was reported by only 34% of patients (P < 0.05). Despite general information about all advanced imaging techniques was given in the media campaigns, patients were most interested in chromoendoscopy (baseline: 5% – after 12 months: 22%), endomicroscopy (5% vs. 17%), CT colonography (16% vs. 37%) and capsule endoscopy (12% vs. 47%). The overall grade of information increased significantly from 14% at baseline to 35% after 12 months (P < 0.05). The percentage of patients who decided to undergo colonoscopy because of the offer of new imaging methods increased significantly from 12% at baseline to 42% after 12 months (P < 0.05).

Conclusion: Patients were highly interested in the offer of advanced imaging techniques. Knowledge about these techniques could relatively easy be assigned by using local media campaigns. The offer of advanced imaging techniques lead to higher acceptance rates for screening or surveillance colonoscopies.