Patients do not recall important details about polyps, required for colorectal cancer prevention

Background & aims: Guidelines recommend that the age of initiation and frequency of colorectal cancer screening or surveillance be based on patients' personal and family histories of colorectal neoplasia. However, it is not clear whether patients accurately recall results from their colonoscopy examinations or features of specific polyps.

Methods: Between 2008 and 2011, a 35-question survey was given to outpatients at the Digestive Disease Institute at the Cleveland Clinic who had previously undergone colonoscopy there. We collected responses from 233 participants (mean age, 59 y; 49% male); they provided demographic information, along with responses to questions on past colonoscopies, personal and family history of colorectal neoplasia, detection of polyps by colonoscopy, and number and other key features of polyps detected. Patient responses were compared with medical records.

Results: Of the patients surveyed, 82% correctly recalled the presence or absence of polyp(s). Of the 118 who correctly reported having polyps, 61% correctly recalled the number, 26% recalled the size, and 6%-33% recalled features of polyp pathology. Only 8% of individuals correctly recalled all 3 key features of polyps (size, number, and pathology). The patients' age when they underwent colonoscopy, current age, sex, education, or method by which they received their colonoscopy results did not significantly affect the accuracy with which they recalled the presence or key features of polyps.

Conclusions: Eighty-two percent of patients examined by colonoscopy correctly recalled whether or not they had polyp(s). However, most patients did not recall key details about their polyps (number, size, or pathology features) required to establish appropriate screening and surveillance intervals. New tools are needed to ensure that patients understand the importance of their colonoscopy findings and improve their recall accuracy.