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Timeliness of Colonoscopy After Abnormal Fecal Test Results in a Safety Net Practice

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Abstract

Fecal testing can only reduce colorectal cancer mortality if patients with an abnormal test result receive a follow-up colonoscopy. As part of the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC) project, we examined factors associated with adherence to follow-up colonoscopy among patients with abnormal fecal test results. As part of STOP CRC outreach, Virginia Garcia Memorial Health Center staff distributed 1753 fecal immunochemical tests (FIT), of which 677 (39 %) were completed, and 56 had an abnormal result (8 %). Project staff used logistic regression analyses to examine factors associated with colonoscopy referral and completion. Of the 56 patients with abnormal FIT results; 45 (80 %) had evidence of a referral for colonoscopy, 32 (57 %) had evidence of a completed colonoscopy within 18 months, and 14 (25 %) within 60 days of an abnormal fecal test result. In adjusted analysis, Hispanics had lower odds of completing follow-up colonoscopy within 60 days than non-Hispanic whites (adjusted OR 0.20; 95 % CI 0.04, 0.92). Colonoscopy within 60 days trended lower for women than for men (adjusted OR 0.25; 95 % CI 0.06–1.04). Among the 24 patients lacking medical record evidence of a colonoscopy, 19 (79 %) had a documented reason, including clinician did not pursue, patient refused, and colonoscopy not indicated. No reason was found for 21 %. Improvements are needed to increase rates of follow-up colonoscopy completion, especially among female and Hispanic patients.

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Acknowledgments

Research reported in this publication was supported by the National Institutes of Health through the National Center for Complementary &Alternative Medicine under Award Number UH2AT007782 and the National Cancer Institute under Award Number 4UH3CA188640-02. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Complementary & Alternative Medicine or the National Cancer Institute. Dr. Saha’s contribution to this work was supported with resources and the use of facilities at the VA Portland Health Care System.

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Authors and Affiliations

  1. Kaiser Permanente Northwest, Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA

    Ann Oluloro, Amanda F. Petrik, Tanya Kapka, Jennifer Rivelli & Gloria D. Coronado

  2. Oregon Health & Sciences University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA

    Ann Oluloro, Patricia A. Carney & Somnath Saha

  3. Virginia Garcia Memorial Health Center, 226 SE 8th Ave, Hillsboro, OR, 97123, USA

    Ann Turner & Tanya Kapka

  4. Section of General Internal Medicine, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd. (P3HSRD), Portland, OR, 97239, USA

    Somnath Saha

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  1. Ann Oluloro
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  2. Amanda F. Petrik
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Correspondence to Ann Oluloro.

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Oluloro, A., Petrik, A.F., Turner, A. et al. Timeliness of Colonoscopy After Abnormal Fecal Test Results in a Safety Net Practice. J Community Health 41, 864–870 (2016). https://doi.org/10.1007/s10900-016-0165-y

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  • DOI: https://doi.org/10.1007/s10900-016-0165-y

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