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ObjectivesTo determine patient acceptability of barium enema (BE) or CT colonography (CTC).MethodsAfter ethical approval, 921 consenting patients with symptoms suggestive of colorectal cancer who had been randomly assigned and completed either BE (N = 606) or CTC (N = 315) received a questionnaire to assess experience of the clinical episode including bowel preparation, procedure and complications. Satisfaction, worry and physical discomfort were assessed using an adapted version of a validated acceptability scale. Non-parametric methods assessed differences between the randomised tests and the effect of patient characteristics.ResultsPatients undergoing BE were significantly less satisfied (median 61, interquartile range [IQR] 54-67 vs. median 64, IQR 56-69; p = 0.003) and experienced more physical discomfort (median 40, IQR 29-52 vs. median 35.5, IQR 25-47; p < 0.001) than those undergoing CTC. Post-test, BE patients were significantly more likely to experience 'abdominal pain/cramps' (68% vs. 57%; p = 0.007), 'soreness' (57% vs. 37%; p < 0.001), 'nausea/vomiting' (16% vs. 8%; p = 0.009), 'soiling' (31% vs. 23%; p = 0.034) and 'wind' (92% vs. 84%; p = 0.001) and in the case of 'wind' to also rate it as severe (27% vs. 15%; p < 0.001).ConclusionCTC is associated with significant improvements in patient experience. These data support the case for CTC to replace BE.

Original publication




Journal article


European radiology

Publication Date





2046 - 2055


Department of Epidemiology and Public Health, University College London, London, UK.


SIGGAR Investigators, Humans, Colonic Neoplasms, Abdominal Pain, Barium, Contrast Media, Colonography, Computed Tomographic, Colonoscopy, Enema, Reproducibility of Results, Choice Behavior, Aged, Middle Aged, Patient Satisfaction, Female, Male, Surveys and Questionnaires