Colon cancer is the second leading cause of cancer-related death in the United States, and colonoscopy is considered the gold standard for colorectal cancer screening. Only 59% of age-eligible adults were up to date with colorectal cancer screening in 2021. Pre-procedural anxiety is a common barrier to completing colonoscopy, and prior studies have reported that more than half of patients experience moderate-to-severe anxiety. Patients may feel anxious about the difficult preparation process, the invasiveness of the procedure, embarrassment, pain or discomfort, possible complications, and the possibility of a cancer diagnosis.
Emerson et al. [Cancer Causes & Control] developed a mindfulness-based intervention (MBI) “For peace of mind. Get Screened” to reduce anxiety before a first-time screening colonoscopy and conducted a pilot randomized controlled trial to evaluate its feasibility, acceptability, and preliminary efficacy.
The researchers randomly assigned 100 patients (average age = 50 years; 52% female; 73% white) scheduled for their first-time colonoscopy to the MBI or usual care. On each of the five days prior to the scheduled colonoscopy, MBI participants were directed to go online to access a colonoscopy infographic, a mindfulness infographic, and brief audio-guided mindfulness meditation that emphasized monitoring and acceptance. After each meditation, participants completed a measure of state mindfulness and rated their satisfaction with the meditation. Data were collected at baseline, during bowel preparation, in the waiting room before colonoscopy, the day after colonoscopy, and through post-colonoscopy chart review.
Out of the 100 participants, 17 were lost to follow-up. Loss to follow-up occurred because the colonoscopy was canceled or rescheduled (n=11) or because the participant became inactive, defined as missing two consecutive days of study activities (n=6). Over 81% of MBI participants accessed the assigned study activities daily; 85% found the mindfulness meditations helpful during bowel prep; 95% found them helpful immediately prior to the colonoscopy; and 98% would recommend the MBI to others. Average satisfaction with the MBI was 6.4 out of 7.
The results suggest a mixed pattern. MBI participants lowered their anxiety scores over time (from baseline to immediately before the colonoscopy), while controls raised their anxiety scores yielding a significant interaction effect. There were no significant between-group differences in total mindfulness scores at follow-up, adequacy of bowel prep, procedure complications or colonoscopy findings.
Overall, this pilot study suggests the MBI program was acceptable and partially feasible and that it may help reduce pre-procedural anxiety before a first-time screening colonoscopy. The study did not report an effect size for the anxiety outcome, so it clinical relevance remained unclear.
Reference:
Emerson, B., Reiter, P. L., Shoben, A. B., Klatt, M., Chakraborty, S., & Katz, M. L. (2026). A pilot randomized controlled trial of an online mindfulness-based intervention to reduce patient anxiety before a first-time screening colonoscopy. Cancer Causes & Control.
Link to study
