Reasons for No Colonoscopy After an Unfavorable Screening Result in Dutch Colorectal Cancer Screening: A Nationwide Questionnaire

We are undergraduates studying at The Ohio State University with an interest in your article "Reasons for No Colonoscopy After an Unfavorable Screening Result in Dutch Colorectal Cancer Screening: A Nationwide Questionnaire." One reason we were drawn to your study is because I (Josie) had a family member pass away from colorectal cancer (CRC). Colorectal cancer is one of the most avoidable cancers. Because my family member lacked the ability to see a physician in a timely manner, her CRC was advanced at time of diagnosis.
One reason for not scheduling a colonoscopy stems from listening to negative advice from people outside of the medical field, lacking a professional opinion. These negative ideologies could potentially be overturned if a greater number of patients had an established relationship with a family physician. Clearly, patient understanding of fecal immunochemical testing (FIT) and colonoscopy needs to be improved.
The authors state that the main study limitation was reliance upon self-reported information related to colonoscopy compliance and medical contradictions. Of the individuals who did not get a colonoscopy, 55.3% indicated their decision was based upon a medical contradiction. Because of the significance and seriousness of not getting a colonoscopy, we think it would be worthwhile to further closely investigate what symptoms/conditions were most predictive of not following up on a positive FIT. Another important aspect of this study is its applicability to the United States. All Dutch healthcare system differs significantly from the United States. Health insurance type, literacy rates, and access to technology are all important factors to understand how well this study could translate to the United States.