Skip to main content
SpringerLink
Log in

Patient Non-adherence and Cancellations Are Higher for Screening Colonoscopy Compared with Surveillance Colonoscopy

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

A significant proportion of the eligible population is non-adherent to colonoscopy for colorectal cancer (CRC) screening.

Aims

To define the demographic and clinical variables associated with non-adherence and multiple cancellations to scheduled colonoscopy within 1 year in a CRC screening and adenomatous polyp surveillance population.

Methods

This was an observational cohort study of 617 consecutive patients scheduled to undergo colonoscopy at an outpatient academic tertiary care center for CRC screening or adenomatous polyp surveillance from January 2012 to September 2012.

Results

Overall, 551 patients (89.3 %) were adherent and 66 (10.7 %) were non-adherent to scheduled colonoscopy at 1 year. The relative risk for non-adherence was 5.42 [95 % confidence interval (CI) 2.74–10.75] in patients undergoing colonoscopy for screening compared to those for surveillance (16.7 vs. 3.5 % non-adherence, respectively, P < 0.001). An indication of screening in comparison with surveillance was associated with non-adherence [odds ratio (OR) 12.69, 95 % CI 4.18–38.51] and multiple cancellations (OR 2.33, 95 % CI 1.27–4.31) by multiple regression analysis.

Conclusions

Patients undergoing colonoscopy for CRC screening are significantly less likely to attend their scheduled procedure within a year and have more procedure cancellations than those undergoing surveillance colonoscopy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention (CDC). Vital signs: CRC screening, incidence, and mortality—United States, 2002–2010. MMWR Morb Mortal Wkly Rep. 2011;60:884–889.

    Google Scholar 

  2. Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–857.

    Article  PubMed  Google Scholar 

  3. Baxter NN, Goldwasser MA, Paszat LF, et al. Association of colonoscopy and death from colorectal cancer. Ann Intern Med. 2009;150:1–8.

    Article  PubMed  Google Scholar 

  4. Nishihara R, Wu K, Lochhead P, et al. Long-term colorectal-cancer incidence and mortality after lower endoscopy. N Engl J Med. 2013;369:1095–1105.

    Article  CAS  PubMed  Google Scholar 

  5. Turner BJ, Weiner M, Yang C, et al. Predicting adherence to colonoscopy or flexible sigmoidoscopy on the basis of physician appointment-keeping behavior. Ann Intern Med. 2004;140:528–532.

    Article  PubMed  Google Scholar 

  6. Jackson DS, Egbuonnu N, Umunakwe C, et al. Scheduled out-patient endoscopy and lack of compliance in a minority serving tertiary institution. Am J Med Sci. 2012;344:194–198.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Badurdeen DS, Umar NA, Begum R, et al. Timing of procedure and compliance with outpatient endoscopy among an underserved population in an inner-city tertiary institution. Ann Epidemiol. 2012;22:531–535.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kazarian ES, Carreira FS, Toribara NW, et al. Colonoscopy completion in a large safety net health care system. Clin Gastroenterol Hepatol. 2008;6:438–442.

    Article  PubMed  Google Scholar 

  9. Adams LA, Pawlik J, Forbes GM. Nonattendance at outpatient endoscopy. Endoscopy. 2004;36:402–404.

    Article  CAS  PubMed  Google Scholar 

  10. Gurudu SR, Fry LC, Fleischer DE, et al. Factors contributing to patient nonattendance at open-access endoscopy. Dig Dis Sci. 2006;51:1942–1945.

    Article  PubMed  Google Scholar 

  11. Turner BJ, Weiner M, Berry SD, et al. Overcoming poor attendance to first scheduled colonoscopy: a randomized trial of peer coach or brochure support. J Gen Intern Med. 2008;23:58–63.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Naylor K, Ward J, Polite BN. Interventions to improve care related to colorectal cancer among racial and ethnic minorities: a systematic review. J Gen Intern Med. 2012;27:1033–1046.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Jandorf L, Stossel LM, Cooperman JL, et al. Cost analysis of a patient navigation system to increase screening colonoscopy adherence among urban minorities. Cancer. 2013;119:612–620.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Wong VK, Zhang HB, Enns R. Factors associated with patient absenteeism for scheduled endoscopy. World J Gastroenterol. 2009;15:2882–2886.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Denberg TD, Melhado TV, Coombes JM, et al. Predictors of nonadherence to screening colonoscopy. J Gen Intern Med. 2005;20:989–995.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Lukin DJ, Jandorf LH, Dhulkifl RJ, et al. Effect of comorbid conditions on adherence to colorectal cancer screening. Cancer Educ. 2012;27:269–276.

    Article  Google Scholar 

  17. Weiss JM, Smith MA, Pickhardt PJ, et al. Predictors of colorectal cancer screening variation among primary-care providers and clinics. Am J Gastroenterol. 2013;108:1159–1167.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Sonnenberg A. How to overbook procedures in the endoscopy unit. Gastrointest Endosc. 2009;69:710–715.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Assistance with data acquisition by Ms. Rosa Burke is gratefully acknowledged. Funding for this study was supported in part by the American Cancer Society Grant No. 255086.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, 1725 West Harrison, Suite 206, Chicago, IL, 60612, USA

    Michael Greenspan, Navdeep Chehl, Krista Shawron, John Losurdo, Sohrab Mobarhan & Joshua Melson

  2. Department of Neurological Sciences and Behavioral Sciences, Rush University Medical Center, 600 S. Paulina Street, Suite 1022g, Chicago, IL, 60612, USA

    Lisa Barnes

  3. Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Triangle Office Building, Suite 470, Chicago, IL, 60612, USA

    Hong Li & Elizabeth Avery

  4. Rush University Medical Center, 1700 W. Van Buren, Triangle Office Building, Suite 371, Chicago, IL, 60612, USA

    Shannon Sims

Authors
  1. Michael Greenspan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Navdeep Chehl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Krista Shawron
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lisa Barnes
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elizabeth Avery
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shannon Sims
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. John Losurdo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sohrab Mobarhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Joshua Melson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joshua Melson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Greenspan, M., Chehl, N., Shawron, K. et al. Patient Non-adherence and Cancellations Are Higher for Screening Colonoscopy Compared with Surveillance Colonoscopy. Dig Dis Sci 60, 2930–2936 (2015). https://doi.org/10.1007/s10620-015-3664-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-015-3664-2

Keywords

Search

Navigation