Will They Show? Predictors of Nonattendance for Scheduled Screening Colonoscopies at a Safety Net Hospital. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: O'Neil, Jessica; Winter, Ethan; Hemond, Colin; Fass, Ronnie
• Is Part Of: Journal of clinical gastroenterology. Volume 55:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: colorectal neoplasms -- early detection of cancer -- colonoscopy -- socioeconomic factors -- chronic obstructive pulmonary disease -- preventative medicine -- nonattendance; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000001332
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Background: Colonoscopy can reduce colorectal cancer–related mortality by up to 90% through early detection and polyp removal. Despite this, nonattendance rates for scheduled colonoscopies have been reported ranging from 4.1% to as high as 67% depending on the population studied. Aim: The aim of the study was to measure the nonattendance rate for scheduled screening colonoscopy at a large safety net hospital and identify predictors of nonattendance within this patient population. Materials and Methods: This was a population-based study of 1186 adults who were scheduled to undergo screening colonoscopy at a safety net hospital as part of their routine preventative health program. Health systems variables were assessed including procedure time and scheduling patterns as well as patient-centered variables such as socioeconomic indicators and specific comorbid diagnoses. Associations with nonattendance were examined by univariate and multivariate logistic regression. Results: The overall rate of nonattendance for scheduled screening colonoscopy was 33%. A multivariate model was constructed to predict nonattendance revealing that private payer status [odds ratio (OR)=0.368, 95% confidence interval (CI): 0.225, 0.602] and prior colonoscopy (OR=0.371, 95% CI: 0.209, 0.656) were associated with greater attendance rates. Chronic obstructive pulmonary disease (OR=2.034, 95% CI: 1.239, 3.341), afternoon procedure time (OR=1.807, 95% CI: 1.137, 2.871), and a greater interval time between the date the colonoscopy was ordered and the date the colonoscopy was scheduled to occur (OR=1.005, 95% CI: 1.001, 1.009) were independently associated with nonattendance when controlling for age, sex, and race. Conclusions: Specific predictors for scheduled screening colonoscopy nonattendance at a safety net hospital can be identified. These findings can be used to tailor community-based interventions to improve colorectal cancer screening rates.