PDF(Pubmed)
Abstract：
UNASSIGNED: Social inequalities in colorectal cancer screening participation are evident. Barriers to screening participation include discomfort from diagnostic modalities. We aimed to describe the discomfort experienced from colonoscopy and colon capsule endoscopy (CCE) and investigate the discrepancy between expected and experienced discomfort stratified by socioeconomic status.
UNASSIGNED: A randomised controlled trial was conducted offering half of the colorectal cancer screening invitees the choice between CCE and colonoscopy after a positive faecal immunochemical test. This paper includes those who elected to undergo CCE. A positive CCE elicited referral for a therapeutic colonoscopy. Participants reported their discomfort from CCE and from any following colonoscopies in electronically distributed questionnaires. Discomfort was measured using visual analogue scales and compared between socioeconomic subgroups determined by educational level and income.
UNASSIGNED: The experienced discomfort from CCE and colonoscopy differed significantly between educational levels but not income levels. The bowel preparation contributed the most to the experienced discomfort in both CCE and colonoscopy. The discrepancy between expected and experienced discomfort from colonoscopy increased with increasing educational and income levels. A similar trend was seen in CCE between educational levels but not income levels.
UNASSIGNED: None of the results indicated a higher discomfort in lower socioeconomic subgroups. Regardless of the investigation modality, the bowel preparation was the main contributor to experienced discomfort. The discrepancy between expected and experienced discomfort did not seem to be larger in lower socioeconomic subgroups, indicating that this is not a major barrier causing inequalities in screening uptake. This is the first study investigating individual discomfort discrepancy in both CCE and colonoscopy, while being able to stratify by socioeconomic status.
UNASSIGNED: A randomised controlled trial was conducted offering half of the colorectal cancer screening invitees the choice between CCE and colonoscopy after a positive faecal immunochemical test. This paper includes those who elected to undergo CCE. A positive CCE elicited referral for a therapeutic colonoscopy. Participants reported their discomfort from CCE and from any following colonoscopies in electronically distributed questionnaires. Discomfort was measured using visual analogue scales and compared between socioeconomic subgroups determined by educational level and income.
UNASSIGNED: The experienced discomfort from CCE and colonoscopy differed significantly between educational levels but not income levels. The bowel preparation contributed the most to the experienced discomfort in both CCE and colonoscopy. The discrepancy between expected and experienced discomfort from colonoscopy increased with increasing educational and income levels. A similar trend was seen in CCE between educational levels but not income levels.
UNASSIGNED: None of the results indicated a higher discomfort in lower socioeconomic subgroups. Regardless of the investigation modality, the bowel preparation was the main contributor to experienced discomfort. The discrepancy between expected and experienced discomfort did not seem to be larger in lower socioeconomic subgroups, indicating that this is not a major barrier causing inequalities in screening uptake. This is the first study investigating individual discomfort discrepancy in both CCE and colonoscopy, while being able to stratify by socioeconomic status.
摘要：
■参与结直肠癌筛查的社会不平等是显而易见的。筛查参与的障碍包括诊断方式的不适。我们旨在描述结肠镜检查和结肠胶囊内镜（CCE）所经历的不适，并调查按社会经济状况分层的预期不适和经历不适之间的差异。
■进行了一项随机对照试验，为一半的大肠癌筛查受邀者提供了粪便免疫化学试验阳性后CCE和结肠镜检查之间的选择。本文包括那些选择接受CCE的人。CCE阳性导致转诊为治疗性结肠镜检查。参与者在电子分发的问卷中报告了CCE和以下结肠镜检查的不适。使用视觉模拟量表测量不适感，并在由教育水平和收入确定的社会经济亚组之间进行比较。
■CCE和结肠镜检查所经历的不适在教育水平而非收入水平之间存在显著差异。在CCE和结肠镜检查中，肠道准备对经历的不适贡献最大。结肠镜检查的预期不适和经历不适之间的差异随着教育和收入水平的提高而增加。在教育水平而不是收入水平之间的CCE中也看到了类似的趋势。
■没有一个结果表明社会经济水平较低的亚组有较高的不适感。不管调查方式如何，肠道准备是出现不适的主要原因.在较低的社会经济亚组中，预期不适与经历不适之间的差异似乎并不大。表明这不是导致筛查吸收不平等的主要障碍。这是第一项调查CCE和结肠镜检查中个体不适差异的研究，同时能够按社会经济地位分层。
■进行了一项随机对照试验，为一半的大肠癌筛查受邀者提供了粪便免疫化学试验阳性后CCE和结肠镜检查之间的选择。本文包括那些选择接受CCE的人。CCE阳性导致转诊为治疗性结肠镜检查。参与者在电子分发的问卷中报告了CCE和以下结肠镜检查的不适。使用视觉模拟量表测量不适感，并在由教育水平和收入确定的社会经济亚组之间进行比较。
■CCE和结肠镜检查所经历的不适在教育水平而非收入水平之间存在显著差异。在CCE和结肠镜检查中，肠道准备对经历的不适贡献最大。结肠镜检查的预期不适和经历不适之间的差异随着教育和收入水平的提高而增加。在教育水平而不是收入水平之间的CCE中也看到了类似的趋势。
■没有一个结果表明社会经济水平较低的亚组有较高的不适感。不管调查方式如何，肠道准备是出现不适的主要原因.在较低的社会经济亚组中，预期不适与经历不适之间的差异似乎并不大。表明这不是导致筛查吸收不平等的主要障碍。这是第一项调查CCE和结肠镜检查中个体不适差异的研究，同时能够按社会经济地位分层。
