The study is a cross-sectional survey study targeting patients aged 45-75 who had their screening or surveillance colonoscopy postponed or delayed due to the COVID pandemic. Study staff will survey a random subsample of patients to assess anxiety, COVID risk tolerance, cancer worry, willingness to screen and barriers to screening colonoscopy, and preference for colonoscopy and alternative colon cancer screening options. Eligible patients will be sent a survey packet in the mail that will include a cover letter, an information sheet describing the study, an incentive, and the survey. The cover letter will include information for participants to opt-out if they desire. Patients will be asked to complete the survey and return it back to study staff. Consent is implied with return of the survey. For the study, staff plan to invite 300 patients and expect to receive 195 completed surveys. Analyses will examine whether COVID-19 has changed patients' interest in colon cancer screening and the strength of patients' preferences for colonoscopy and other approaches to colon cancer screening. It will then examine factors associated with positive and negative views on rescheduling colonoscopies such as anxiety, worry, and risk perceptions.
The study is a cross-sectional survey study targeting patients aged 45-75 who had their
screening or surveillance colonoscopy postponed or delayed due to the COVID pandemic. Staff
will survey a random subsample of patients to assess anxiety, COVID risk tolerance, cancer
worry, willingness to screen and barriers to screening colonoscopy, and preference for
colonoscopy and alternative colon cancer screening options.
Study staff will work with the gastroenterology department to identify patients whose
colonoscopy has been delayed due to COVID-19 and who meet the eligibility criteria. A random
sample of about 300 eligible patients will be selected for the survey study.
Eligible patients will be sent a survey packet in the mail that will include a cover letter,
an information sheet describing the study, an incentive, and the survey. The cover letter
will include information for participants to opt-out if they desire. Patients will be asked
to complete the survey and return it back to study staff. Patients will also be able to
complete the survey online via a RedCap link. Consent is implied with return of the completed
survey. Staff will make up to three reminder phone calls and will send a reminder packet to
non responders.
The study staff will invite 300 patients and expect to receive about 195 completed surveys.
Analyses will first examine whether there are differences between responders and non
responders. Then, the analysis will examine descriptive statistics exploring patients'
interest in colon cancer screening, strength of preference for switching to stool based
testing or postponing colonoscopy for a year. The analyses will explore patients' perspective
towards colonoscopy in the coming months and factors associated with positive or negative
perceptions of colonoscopy such as anxiety, cancer worry, COVID worry and risk perceptions.
The relationships between these factors will be examined using chi-square analysis (for
categorical data) and correlations (for continuous data). Models will be used to explore
factors associated with different preferences for screening.
Inclusion Criteria:
- Adults, age 45-75
- Had screening or surveillance colonoscopy delayed due to COVID-19
- Either first screening colonoscopy or a routine screening or surveillance colonoscopy
for low to moderate risk patients (as indicated by 3-10 year recommended follow up
frequency from prior test)
Exclusion Criteria:
- Diagnostic colonoscopy
- High risk for colorectal cancer as indicated by 1 year follow up schedule
- Prior history of colon cancer or irritable bowel syndrome
- Unable to read or write in English or Spanish
Massachusetts General Hospital
Boston, Massachusetts, United States
Karen Sepucha, PhD, Principal Investigator
Massachusetts General Hospital