Assessing the Impact of Media Coverage of the NordICC Trial on Public Perspectives on Colonoscopy for Colorectal Cancer Screening.

Abstract

Introduction: Screening tests like colonoscopy can prevent colorectal cancer (CRC), yet their effectiveness is often questioned. The Nordic-European Initiative on Colorectal Cancer (NordICC) trial demonstrated that colonoscopy significantly reduces CRC incidence and mortality in per-protocol analysis. However, media coverage of the trial often focused on intention-to-screen findings that showed no change in mortality, possibly contributing to public confusion about colonoscopy benefits. This study aimed to assess whether such media articles undermined public perception and intent to undergo colonoscopic screening.

Methods: We recruited a US nationally representative sample of unscreened adults aged 45 to 75 years at average CRC risk. Respondents were randomized 1:1 to read either a low-quality or high-quality article on NordICC, as rated by a panel of gastroenterologists. Before and after reading their article, participants reported whether they plan to be screened for CRC with a colonoscopy. Our primary outcome was a negative change in intent to undergo colonoscopic screening.

Results: Among the 2013 participants who completed the survey, 1531 (76.1%) stated they planned to undergo colonoscopy or were undecided before reading the article. After reading the media report, 90 (12.0%) people in the low-quality article arm no longer planned to undergo colonoscopy versus 73 (9.3%) in the high-quality article arm; the difference was not statistically significant (P=0.08).

Discussion: A widely promulgated article about NordICC rated as low-quality did not differentially impact attitudes towards colonoscopic CRC screening compared with another mainstream article rated as high-quality. Our study provides reassurance that most people will not summarily change health behaviors after reading a single article, regardless of perceived accuracy.