Prospective Cohort study of Predictors of Follow-Up Diagnostic Colonoscopy from a Pragmatic Trial of FIT Screening

• Published in: Scientific reports 2020-02, Vol.10 (1), p.2441-2441, Article 2441
• Main Authors: O’Connor, Elizabeth A., Nielson, Carrie M., Petrik, Amanda F., Green, Beverly B., Coronado, Gloria D.
• Format: Article
• Language: English
• Subjects: 692/4028/67/2195; 692/4028/67/2322; Aged; Cohort analysis; Colon cancer; Colonoscopy; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Early Detection of Cancer; Electronic medical records; Feces - chemistry; Female; Follow-Up Studies; Humanities and Social Sciences; Humans; Immunochemistry; Male; Mass Screening; Middle Aged; multidisciplinary; Neighborhoods; Population studies; Prognosis; Prospective Studies; Public Health; Science; Science (multidisciplinary); Secondary analysis; Subpopulations; United States - epidemiology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-59032-0

The goal of this study was to explore diagnostic colonoscopy completion in adults with abnormal screening fecal immunochemical test (FIT) results. This was a secondary analysis of the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (Stop CRC) study, a cluster-randomized pragmatic trial to increase uptake of CRC screening in federally qualified community health clinics. Diagnostic colonoscopy completion and reasons for non-completion were ascertained through a manual review of electronic health records, and completion was compared across a wide range of individual patient health and sociodemographic characteristics. Among 2,018 adults with an abnormal FIT result, 1066 (52.8%) completed a follow-up colonoscopy within 12 months. Completion was generally similar across a wide range of participant subpopulations; however, completion was higher for participants who were younger, Hispanic, Spanish-speaking, and had zero or one of the Charlson medical comorbidities, compared to their counterparts. Neighborhood-level predictors were not associated with diagnostic colonoscopy completion. Thus, completion of a diagnostic colonoscopy was relatively low in a large sample of community health clinic adults who had an abnormal screening FIT result. While completion was generally similar across a wide range of characteristics, younger, healthier, Hispanic participants tended to have a higher likelihood of completion.