Colorectal Cancer Screening Project | 2023-4_Effective Strategies to Improve

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This document is a summary of a presentation on effective strategies to improve follow-up colonoscopy after abnormal stool-based colorectal cancer (CRC) screening. The presentation was given at the American Society for Gastrointestinal Endoscopy CRC Screen Project National Summit. The study aimed to develop and test a CRC Screening Follow-Up Measure that measures the receipt of timely follow-up with a colonoscopy after a positive stool-based screening test for colorectal cancer.<br /><br />The study used a mixed methods design, including a retrospective analysis of data from the Optum Labs Data Warehouse and semi-structured clinician interviews. The study found that 49% of individuals did not receive a follow-up colonoscopy within 6 months after a positive stool-based test. Factors associated with lower follow-up rates included Black or Asian race, Medicare or Medicaid insurance, and a fecal immunochemical test (FIT) screening test compared to a multitarget stool DNA test (mt-sDNA).<br /><br />Qualitative insights from healthcare providers revealed that there was a lack of knowledge about the failure to follow-up and patient hesitancy around colonoscopy due to discomfort and cost concerns. Trust and communication between providers and patients were seen as facilitators to completing follow-up.<br /><br />The study concluded that there is a need for effective strategies to improve follow-up colonoscopy rates after abnormal stool-based CRC screening. The results highlight the importance of addressing disparities in follow-up rates among different racial and insurance groups. The findings also suggest the need for improved communication between providers and patients, as well as the integration of gastroenterology departments and better tracking and reporting of follow-up rates. The study has implications for developing quality measures and interventions to improve follow-up rates in CRC screening programs.

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Elizabeth Ciemins, PhD, MPH, MA

Keywords

follow-up colonoscopy

abnormal stool-based CRC screening

colorectal cancer

strategies to improve

American Society for Gastrointestinal Endoscopy

CRC Screen Project National Summit

CRC Screening Follow-Up Measure

timely follow-up

positive stool-based screening test

mixed methods design