Objectives It is unclear if provider recommendations regarding colorectal cancer (CRC) screening modalities affect patient compliance. We evaluated provider-patient communications about CRC screening with and without a specific screening modality recommendation on patient compliance with screening guidelines. Methods We used the 2007 Health Information National Trends Survey (HINTS) and identified 4,283 respondents who were at least 50 years of age and answered questions about their communication with their care providers and CRC screening uptake. We defined being compliant with CRC screening as the use of fecal occult blood testing (FOBT) within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We used survey weights in all analyses. Results CRC screening discussions occurred with 3,320 (76.2%) respondents. Approximately 95% of these discussions were with physicians. Overall, 2,793 (62.6%) respondents were current with CRC screening regardless of the screening modality. Discussion about screening (Odds Ratio (OR)=8.83; 95%CI: 7.20–10.84) and providers making a specific recommendation about screening modality rather than leaving it to the patient to decide (OR=2.04; 95%CI: 1.54–2.68) were associated with patient compliance with CRC screening guidelines. Conclusion Compliance with CRC screening guidelines is improved when providers discuss options and make specific screening test recommendations.

Background: It is unclear whether there is a shared pathway in the development of diverticular disease (DD) and potentially neoplastic colorectal lesions since both diseases are found in similar age groups and populations. Aim: To determine the association between DD and colorectal pre-neoplastic lesions in an African-American urban population. Methods: Data from 1986 patients who underwent colonoscopy at the Howard University Hospital from January 2012 through December 2012 were analyzed for this study. The presence of diverticula and polyps was recorded using colonoscopy reports. Polyps were further classified into adenoma or hyperplastic polyp based on histopathology reports. Multiple logistic regression was done to analyze the association between DD and colonic lesions. Results: Of the 1986 study subjects, 1,119 (56%) were females, 35% had DD and 56% had at least one polyp. There was a higher prevalence of polyps (70 vs. 49%; OR = 2.3; 95% CI: 1.9-2.8) and adenoma (43 vs. 25%; OR = 2.0; 95% CI: 1.7-2.5) in the diverticular vs. non-diverticula patients. Among patients who underwent screening colonoscopy, the presence of diverticulosis was associated with increased odds of associated polyps (OR = 9.9; 95% CI: 5.4-16.8) and adenoma (OR = 5.1; 95% CI: 3.4-7.8). Conclusion: Patients with DD are more likely to harbor colorectal lesions. These findings call for more vigilance on the part of endoscopists during colonoscopy in patients known to harbor colonic diverticula.

The finding that C9-deficient sera (C9D) can kill serum sensitive strains of Gram-negative bacteria by us and other investigators, questions the role of C9 in the membrane attack complex as necessary for cell death. In these studies we have demonstrated that C5b-8 complexes generated on E. coli J5 during incubation in C9-depleted and C9-neutralized sera are effective in killing Gram-negative bacteria. In the same study, we extended our investigations to show that the deposition of C5b-7 complexes (from C8-deficient [C8D], C8 depleted and C8-neutralized sera) is also effective in killing Gram-negative bacteria. In all cases, these studies demonstrated that when E. coli J5 was incubated with C8D, C9D and pooled normal human serum [PNHS], deposited C5b-9 complexes from PNHS produced more killing than C5b-7 or C5b-8 complexes alone. These experiments clearly demonstrated that C5b-7 and C5b-8 complexes are bactericidal and that multimeric C9 within C5b-9 is not an absolute requirement for inner membrane damage and cell death of Gram-negative bacteria.

Background Lack of adherence to appointments wastes resources and portends a poorer outcome for patients. We sought to determine if the type of scheduled endoscopic procedures affect compliance. Methods We reviewed the final endoscopy schedule from January 2010 to August 2010 in an inner city teaching hospital that serves a predominantly African American population. The final schedule only includes patients who did not cancel, reschedule or notify the facility of their inability to adhere to their care plan up to 24 hours prior to their procedures. All patients had face to face consultation with gastroenterologists or surgeons prior to scheduling. We identified patients who did not show up for their procedures. We used Poisson regression models to calculate Relative Risks (RR) and 95% Confidence Intervals (CI). Results Of 2,183 patients who were scheduled for outpatient endoscopy, 400 (18.3%) patients were scheduled for Esophago-gastro-duodenoscopy (EGD), 1,335 (61.2%) for colonoscopy and 448 (20.5%) for both EGD and colonoscopy. The rate of non compliance was 17.5%, 22.8% and 22.1%, respectively. When compared to those scheduled for only EGD, patients scheduled for colonoscopy alone (RR = 1.47; 95%CI: 1.13-1.92) and patients scheduled for both EGD and colonoscopy (RR = 1.36; 95%CI: 1.01-1.84) were less likely to show up for their procedures. Conclusions Our study suggests a high rate of non-compliance with scheduled out-patient endoscopy, particularly for colonoscopy. Since this may be a contributing factor to colorectal cancer disparities, increased community outreach on colorectal cancer education is needed and may help to reduce non compliance.

This research was approved by the institution review board of Howard University, Washington DC (IRB-21-MED-18).Publisher's Note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Laiyemo et al.: Healthcare Workers' Perception of Safety and Covid Vaccine Uptake JGIM