To describe interventions that enhance adherence to colorectal cancer screening programs, after mapping the scientific evidence on the fears and emotions experienced by patients undergoing colonoscopy, as well as the associated variables.

To examine which interventions may increase adherence to colonoscopy, a scoping review was conducted according to the Joanna Briggs Institute Protocol, guided by the research question: “What are the fears and emotions associated with undergoing a colonoscopy, and the related variables?” A literature search was carried out in the PubMed, CINAHL, Scopus, and RCAAP databases in June 2025, including articles in Portuguese, English, and Spanish. These findings enabled the identification of targeted interventions and strategies capable of improving patient adherence to colorectal cancer screening programmes.

Colonoscopy is considered the gold standard for the diagnosis and treatment of gastrointestinal diseases^(1,2). It is associated with a significant reduction in CRC mortality and is highly sensitive in detecting tumors, polyps, ulcers, active bleeding, and inflammatory disease⁽³⁾. However, achieving widespread adherence to colonoscopy remains a challenge⁽³⁾, as despite its clinical benefits, it is an uncomfortable procedure in which pain and fear of the unknown generate anxiety and stress in many patients^(2,4). Studies show that colonoscopy is often perceived negatively by society and commonly viewed as a source of anxiety and fear, which can prevent patients from undergoing the procedure and cause disruptions in the diagnostic and treatment process, contributing to the rejection of CRC screening programs⁽²⁾. This premise directly addresses the question: “Anxiety before gastrointestinal endoscopy - is it a significant problem?”⁽⁵⁾.

All the circumstances described above justify the need to analyze the frequency and intensity of anxiety caused by colonoscopy, as well as to identify the factors that contribute to this effect and their influence on procedural tolerance⁽¹⁾. Although efforts have been made to improve tolerance through conscious or deep sedation, little attention has been paid to patients’ pre-procedural anxiety⁽¹⁾. According to Cardenal, cited by Olmo-Conesa⁽⁴⁾, undergoing any diagnostic exam such as colonoscopy has emotional consequences for the patient, beginning at the time of scheduling⁽⁶⁾ and continuing through the procedure and the delivery of results. It is considered an acute situation that subsides once the triggering stimulus ends⁽¹⁾. According to the study by Sequeira⁽⁷⁾, a moderate level of state anxiety was observed prior to the exam, which significantly decreased after the procedure, with statistical relevance.

Reported fears and emotions included concerns about medical complications, diagnosis, and pain. Variables such as information about the procedure, previous experiences, and gender influenced anxiety levels. 

Living in harmony with technological advancement requires a reinvention of thought, social interaction, empathy, and community, elements that distinguish humans from machines. It is crucial to reflect on empathy as a counterbalance to technology and its role in supporting and complementing the humanization of care. 

The dissemination of these results aims to positively influence not only the nursing team but the entire multidisciplinary team involved in clinical endoscopic practice. These findings will foster greater awareness among all professionals of what patients experience throughout this process and offer practical applicability in care delivery. They also highlight the need and, above all, the relevance of intensifying and deepening research in such a subjective and vast area, supporting the conditions necessary to transform and improve the foundations and paradigms that underpin digestive endoscopy care.