Gordon Moffat
Assistant Clinical Instructor,State University of New York, USA
Title: FIT vs Colonoscopy: Using Social Determinants to Optimize Colorectal Cancer Screening in a Urban Underserved Population
Biography
Biography: Gordon Moffat
Abstract
STATEMENT OF PROBLEM OR QUESTION:
Will improved shared decision making around FIT or colonoscopy screening based on social determinants improve colorectal cancer (CRC) screening completion rates in underserved populations?
OBJECTIVES OF PROGRAM/INTERVENTION:
To compare screening completion rates of FIT vs colonoscopy in an urban underserved population
To improve CRC screening completion rates
DESCRIPTION OF PROGRAM/INTERVENTION:
A retrospective analysis reviewed baseline colon cancer screening rates in resident clinic patients seen between January and February 2017. The intervention was to encourage residents to discuss the pros and cons of FIT and colonoscopy for CRC screening allowing patients to choose their preferred modality. A prospective cohort study reviewed charts from September 1 to Dec 31st 2017 to assess completion of screening. Primary endpoint: overall CRC screening rate.
MEASURES OF SUCCESS:
Overall CRC screening rates pre and post intervention were assessed. A subgroup analysis of FIT and colonoscopy completion rates was performed pre and post intervention.
FINDINGS TO DATE:
The study population consisted largely of Afro-Caribbean patients, 50 years and older with average risk factors at a resident clinic in an urban safety net institution. Of the 52 patients reviewed in the baseline analysis, 9 (17%) FIT and 43 (71%) colonoscopies were ordered, with completion rates of 78% and 26% respectively, and an overall rate of 34%.
Post-intervention, 42 patients agreed to screening between October and December 2017. Of these 42 patients, 30 chose FIT (71%) and 12 favored colonoscopies (29%). Due to the short follow up period, no colonoscopies were completed, however, 73% of FIT testing was still able to be performed. The overall post-intervention completion rate was 52%.