Endoscopy 2008; 40(8): 650-655
DOI: 10.1055/s-2008-1077350
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Colonoscopy is the preferred colorectal cancer screening method in a population-based program

U.  A.  Marbet1 , P.  Bauerfeind2 , J.  Brunner3 , G.  Dorta4 , J.  J.  Valloton5 , F.  Delcò2
  • 1Division of Gastroenterology, Department of Medicine, District Hospital of Uri, Switzerland
  • 2Division of Gastroenterology, Department of Medicine, University Hospital of Zürich, Switzerland
  • 3Division of Gastroenterology, Department of Medicine, District Hospital of Glarus, Switzerland
  • 4Division of Gastroenterology, Department of Medicine, University Hospital of Lausanne, Switzerland
  • 5Medical Office, Vallée de Joux, Switzerland
Further Information

Publication History

submitted 26 March 2007

accepted after revision 22 February 2008

Publication Date:
07 July 2008 (online)

Background and study aims: Various screening methods for colorectal cancer (CRC) are promoted by professional societies; however, few data are available about the factors that determine patient participation in screening, which is crucial to the success of population-based programs. This study aimed (i) to identify factors that determine acceptance of screening and preference of screening method, and (ii) to evaluate procedure success, detection of colorectal neoplasia, and patient satisfaction with screening colonoscopy.

Patients and methods: Following a public awareness campaign, the population aged 50 – 80 years was offered CRC screening in the form of annual fecal occult blood tests, flexible sigmoidoscopy, a combination of both, or colonoscopy.

Results: 2731 asymptomatic persons (12.0 % of the target population) registered with and were eligible to take part in the screening program. Access to information and a positive attitude to screening were major determinants of participation. Colonoscopy was the method preferred by 74.8 % of participants. Advanced colorectal neoplasia was present in 8.5 %; its prevalence was higher in males and increased with age. Significant complications occurred in 0.5 % of those undergoing colonoscopy and were associated with polypectomy or sedation. Most patients were satisfied with colonoscopy and over 90 % would choose it again for CRC screening.

Conclusions: In this population-based study, only a small proportion of the target population underwent CRC screening despite an extensive information campaign. Colonoscopy was the preferred method and was safe. The determinants of participation in screening and preference of screening method, together with the distribution of colorectal neoplasia in different demographic categories, provide a rationale for improving screening procedures.

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F. Delcò, MD MPH 

Division of Gastroenterology
Department of Internal Medicine
University Hospital of Zürich

Raemistrasse 100
8091 Zürich
Switzerland

Fax: +41-44-2554503

Email: Fabiola.Delco@eoc.ch