Role of Repeat Preoperative Endoscopy in Colorectal Cancer: Patients' Perspectives

Background: Repeat preoperative endoscopy is a common practice in colorectal cancer care; however, it is often viewed as inefficient, potentially avoidable, and incurring costs or delays. While provider and system perspectives have been examined, this study aimed to explore patients' experiences and perspectives regarding repeat preoperative colonoscopy to understand its perceived value within the cancer care pathway. Methods: We conducted a qualitative study using semi-structured telephone interviews at a tertiary academic center. Twenty adult patients treated for colorectal cancer (2019-2025) who underwent repeat preoperative endoscopy were recruited to explore their perspectives. Transcripts were analyzed using inductive thematic analysis rooted in grounded theory. Results: Despite the procedural burden, 80% of participants reported a positive overall experience, and 75% perceived a clear benefit from the repeat procedure. Three major themes emerged: (1) Trust and Verification, where patients valued relationship-building with the surgeon and the reassuring "second look" for surgical accuracy and planning; (2) Part of the Patient Journey, where the procedure was accepted and normalized as a manageable step despite the burden of bowel preparation; and (3) Communication and Coordination, where participants highlighted gaps in care plan comprehension and logistical navigation. Conclusions: Patients largely accepted repeat preoperative endoscopy as a justified and reassuring component of their care, fostering trust in the surgical plan, rather than perceiving it as a redundant or burdensome delay in their treatment. This counter-narrative to traditional provider-focused metrics suggests that while system efficiency remains important, repeat endoscopy provides a unique opportunity for enhancing the patient-provider therapeutic alliance.