Patient-reported outcomes and measures applied in individuals undergoing colonoscopy surveillance for colorectal cancer: a scoping review

Abstract

PURPOSE: Clinical guidelines recommend regular colonoscopy surveillance for individuals at elevated risk for colorectal cancer (CRC). While colonoscopy surveillance is proven to reduce the incidence of CRC, colonoscopy is an invasive procedure that can impact patient-reported outcomes (PROs). Assessment of PROs is recommended as a key indicator of the quality of health service delivery. However, there is no standard set of PROs and PRO measures (PROMs) to be applied in individuals undergoing regular surveillance colonoscopy. The aim of this scoping review was to identify PROs and PROMs applied for this population. METHODS: The review followed the Joanna Briggs Institute guidelines. Five databases were searched: Medline (OVID), Scopus, Web of Science, CINAHL, and PsycINFO (OVID). Data extracted included the PROs assessed, PROMs used, indications for surveillance colonoscopy, and assessment timepoints. RESULTS: 8684 studies were screened, and 91 were included. Eighteen PROs and 12 PROMs were identified. Abdominal discomfort (60%), abdominal pain (60%) and nausea (56%) were the most frequently collected PROs. PROs were predominantly assessed after bowel preparation/before colonoscopy (55%) and 1-2 days after colonoscopy (48%). Hospital Anxiety and Depression Scale (33.3%), Short Form-36 (33%), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30-item (27%), and EQ-5D-5L (20%) were the most frequently used PROMs. CONCLUSION: There is variability in PROs and PROMs applied. This highlights the need for consensus on a standardised set of PROs to be assessed and PROMs to facilitate consistent and reliable data collection to better inform implementation and improve healthcare quality.