Improving Colorectal Cancer Screening Rates in Patients Referred to a Gastroenterology Clinic

Abstract

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer related death in the United States. Colonoscopy and fecal immunochemistry testing are the primary recommended CRC screening modalities. The purpose of this study is to improve rates of CRC screening in Veterans and County hospital patients referred to gastroenterology fellow's clinics. A total of 717 patients between the ages of 49 and 75 (mean 62.0 ± 6.5) were seen. Prior CRC screening was not done in 109 (15.2%) due to not being offered (73.4%) or declining (26.6%) screening. Patients who received prior CRC screening compared to no prior screening were older (mean age 62.3 ± 6.4 vs 60.3 ± 6.8, p=0.003), white race (88.6% vs 78.3%, p=0.027), and more likely to be Veterans patients (90.8% vs 77.5%, p<0.001). After systematically discussing options for screening with 78 of the 109 unscreened patients, 56 of them (71.8%) underwent screening with either colonoscopy (32) or FIT (24). Patients seen by fellows in their last year of training agreed to undergo screening more often than those seen by other fellows (100% vs 66.2%, p=0.033). Systematic discussions about both colonoscopy and FIT can improve overall rates of CRC screening.