Participant’s experience of colonoscopy to improve bowel surveillance

Lead researcher: Professor Katie Robb 

Location: University of Glasgow 

Grant award: £24,986 

Professor Robb studied how people feel about being invited to future colonoscopies if they’ve already had polyps (non-cancerous growths) removed and what barriers there are to attending. 

The challenge 

When people take part in bowel screening and the poo test finds blood in their poo, they’re invited for a colonoscopy. Around 1 in 20 will be found to have cancer. But, more people will have a precancerous growth called a polyp. This can be removed during the colonoscopy.  

Some people who have had a polyp removed can have a higher risk of getting further polyps in the future, which can develop into bowel cancer. These people are invited back for another colonoscopy to check (called a surveillance colonoscopy) three years later.  

The success of bowel screening relies on people taking part in tests when invited. There’s been a lot of work to improve uptake of poo testing and initial colonoscopies, but not much research into surveillance colonoscopies. Some people find colonoscopies unpleasant. This means they might not like colonoscopies as a way to check for bowel cancer after polyps are removed. They also might avoid or miss their appointments when they’re invited back.

The science behind the project 

Professor Robb’s team interviewed people who have had polyps removed in a colonoscopy after bowel screening and will be invited to a future surveillance colonoscopy. The researchers wanted to understand the patients’ experience of colonoscopy, what they think of surveillance colonoscopies and if they faced any barriers to taking part. 

Results 

The interviews showed that, while people find colonoscopies challenging, they understand the importance of surveillance. Having previously had a colonoscopy also helps them to feel more prepared for future procedures. 

What happens next? 

The researchers are using this pilot to inform a larger follow-up study. They will send a questionnaire, developed from the results of the interviews, to a much larger group of people to build a wider picture of how people feel about surveillance colonoscopy. The questionnaire will be sent to people in both high- and low-deprivation areas, to allow the team to compare if there are any differences between these areas. 

They’ll also be talking to healthcare professionals who work in bowel screening and surveillance services to get their perspective on what can affect surveillance participation. 

We're funding the next stage of this work – read more about the follow-up study here.

A better understanding of how patients’ experiences and the barriers they face will help screening programmes support more people to attend surveillance appointments. This can lead to future work testing practical ways to improve uptake and so detect more bowel cancers as early as possible. 

Looking in particular at how areas with more deprivation differ from areas with less deprivation can help reduce screening inequalities.

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