Background: Understanding how IBD patients’ experiences with colonoscopy influence their acceptance and participation in CRC surveillance colonoscopy may facilitate design and implementation of CRC surveillance strategies. The aim of this study was to define IBD patients’ experiences with colonoscopy and their decision-making process regarding CRC surveillance with colonoscopy. Methods: We performed a qualitative study of patients with IBD who had at least 1 colonoscopy for IBD using in-depth interviews. Trained investigators conducted in-depth interviews in-person or via telephone using open-ended questions to elicit data regarding perceptions of barriers and motivators of surveillance colonoscopy and expected outcomes related to CRC surveillance. Results: We interviewed 30 IBD patients (14 CD and 16 UC); 7 were male, and 23 were female, with an age range of 18-74 years. We identified patient-reported motivators and barriers to CRC surveillance colonoscopy (Table 1) and created a patient decision-making model. Patients reported high concern for CRC, yet they often perceived the indication of colonoscopy was for IBD disease management, not for CRC prevention or detection. We identified several novel factors having a negative impact on acceptance of surveillance, including discrepancy in colonoscopy interval recommendations between providers, patient awareness of lack of guideline concordance, and communication with other IBD patients with differing colonoscopy intervals. Conclusions: This study identified motivators and barriers influencing patient decision-making for IBD-related CRC surveillance colonoscopy. We used these factors to develop a model of IBD patient decision-making for CRC surveillance, which may be used to inform development of a multi-component intervention for patient-centered IBD-related CRC surveillance and prevention.
