Reasons for Non–Follow-Up With Colonoscopy
| Reason | No. | % | % of Cases (Nr = 730) |
|---|---|---|---|
| Had a recent colonoscopy | 211 | 14.0 | 28.9 |
| Alternative explanation for positive FITa | 214 | 14.2 | 29.5 |
| Chronic illness | 172 | 11.5 | 23.6 |
| Diagnosis of ulcerative colitis/Crohn disease or other reason for regular visits with gastrointestinal specialist or internist | 130 | 8.7 | 17.8 |
| Advised against colonoscopy by gastrointestinal specialist or internist | 93 | 6.2 | 12.7 |
| Aversion to colonoscopy | 73 | 4.9 | 10.0 |
| FP advised against colonoscopy | 71 | 4.7 | 9.7 |
| Had a second negative FIT | 69 | 4.6 | 9.5 |
| Acute illness | 63 | 4.2 | 8.6 |
| Undergoing cancer treatment | 56 | 3.7 | 7.7 |
| No answer provided | 47 | 3.1 | 6.4 |
| Advised against colonoscopy during intake for colonoscopy | 44 | 2.9 | 6.0 |
| No symptoms/fecal blood has no meaning | 31 | 2.1 | 4.2 |
| Short life expectancy | 30 | 2.0 | 4.1 |
| Medical barrier | 27 | 1.8 | 3.7 |
| Fear of outcome | 25 | 1.7 | 3.4 |
| Practical barrier | 24 | 1.6 | 3.3 |
| Want a second FIT | 17 | 1.1 | 2.3 |
| Want more personalized care | 16 | 1.1 | 2.2 |
| Low perception of risk of CRC | 14 | 0.9 | 1.9 |
| Financial consequences of colonoscopy | 13 | 0.9 | 1.8 |
| Nonmedical priorities | 11 | 0.7 | 1.5 |
| Do not want treatment if CRC is found | 11 | 0.7 | 1.5 |
| Distrust screening test, organization, or process | 11 | 0.7 | 1.5 |
| Other reason, without contraindication | 10 | 0.7 | 1.4 |
| Nurse advised against colonoscopyb | 7 | 0.5 | 1.0 |
| Had a second opinion (CT colonography/MRI) | 6 | 0.4 | 0.8 |
| Dementia, mental disability, severe psychiatric issues | 6 | 0.4 | 0.8 |
| Totalc | 1,502 | 100.0 | 205.8 |
CRC = colorectal cancer; CT = computed tomography; FIT = fecal immunochemical test; FP = family physician; MRI = magnetic resonance imaging; No. = number of times reason was mentioned; Nr = total number of respondents who reported not undergoing colonoscopy, excluding respondents with recent CRC diagnosis and respondents of whom it was unclear if they underwent colonoscopy.
Note: Reasons highlighted in bold were considered a valid contraindication for colonoscopy.30,34
% = proportion of all reasons mentioned; % of cases = proportion of Nr that mentioned reason.
↵a Thinking blood in stool was caused by hemorrhoids, fissure, constipation, medication, or other and not underlying neoplasia.
↵b Refers to care personnel, such as district nurses or homecare, without a medical degree.
↵c Most respondents reported >1 reason.