CRC Screening Results: Patient Comprehension and Follow-up

Revital Azulay, Liora Valinsky, Fabienne Hershkowitz, Racheli Magnezi

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Fecal occult blood tests are recommended for colorectal cancer screening, but are only effective if colonoscopy follows positive results. Patients with positive results often do not complete follow-up. This study examined the association between patient comprehension and adherence to colonoscopy after positive FIT (Fecal Immunochemical Test). Methods: Five hundred twenty-two patients completed a telephone questionnaire regarding the FIT and its implications 120 days after a positive result. Patients were asked whether they had the test, received the results, and required follow-up. These questions were used to identify the degree to which patients understood medical information. A participant who answered “no” to any question was defined as having “low comprehension” regarding the FIT, and participants who answered “yes” to all 3 questions, as having “high comprehension”. Results: Comprehension and colonoscopy adherence were significantly associated. Adherence to colonoscopy was significantly higher among participants with high comprehension, after adjusting for gender, age, education, ethnicity, and socio-economic status. Conclusions: This study demonstrates a link between health comprehension and patient follow-up after positive FIT and contributes to understanding the implications of health comprehension in terms of health promotion. We recommend patients undergoing screening tests receive clear explanations regarding need for follow-up of positive results thus reducing health disparities associated with health comprehension.

Original languageEnglish
JournalCancer Control
Issue number1
StatePublished - 1 Jan 2019

Bibliographical note

Publisher Copyright:
© The Author(s) 2019.


  • cancer screening
  • colonoscopy adherence
  • comprehension
  • health literacy
  • positive colorectal cancer screening


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