Introduction Uninsured patients with low socioeconomic status are at high risk for developing colorectal cancer (CRC), and data on risk factors and prevalence of CRC in this population are limited. The purpose of this study was to assess the risk factors for CRC in uninsured patients from free clinics in the Tampa Bay area of Florida. Methods We conducted a retrospective cohort study among patients 50 years or older who were provided service at 9 free clinics in the Tampa Bay area between 2016 and 2018. Demographics, chronic disease characteristics, and screening data were collected via a query of paper and electronic medical records. Results Of the 13,982 patients seen, 5,139 (36.8%) were aged 50 years or older. Most were female (56.8%), non-Hispanic White (41.1%), and unemployed (54.9%). Patients with CRC screening were more likely to be employed compared with patients without CRC screening (54.4% vs 44.4%, P = .01). Within the cohort, 725 (22.7%) patients were active smokers, 771 (29.2%) patients currently consumed alcohol, and 23 patients (0.4%) had a history of inflammatory bowel disease. Patients had a median body mass index of 29.4 (interquartile range, 25.4–34.2) kg/m 2 , and 1,455 (28.3%) had diabetes. Documented CRC screening was found among 341 (6.6%) patients. Conclusion Uninsured patients had a high prevalence of CRC risk factors but a low reported screening rate for CRC. Free clinics are uniquely positioned to provide patients at high risk for CRC with strategies to decrease their risk and to be screened for CRC.

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INTRODUCTION: Uninsured and under-insured patients with high comorbidity burden are associated with high costs and high needs. GI diseases make up a significant portion of comorbidity burden and annual health expenditures. There is limited data on GI illnesses among the uninsured. The objective of this study is to do a preliminary evaluation of the burden of chronic GI illness in the uninsured community of Tampa Bay, Florida. METHODS: A retrospective query of an IRB approved database of 5076 patients seen across nine free clinics in the Tampa Bay area in 2017 revealed 760 patients with GI illness. Demographics, substance abuse, prevalence of GI illnesses including GERD, metabolic syndrome, irritable bowel syndrome, inflammatory bowel disease, ulcers, hemorrhoids, hepatitis, chronic liver disease, gallstones, and pancreatitis, were analyzed. Statistical analysis was performed with R 3.5.3. RESULTS: GI patients had a preponderance to be female (62.5%) and Hispanic (57.0%). GERD was the most prevalent condition (13.5%) followed by chronic liver disease (3.6%), GI ulcer (3.2%), hemorrhoids (2.2%), hepatitis C (1.6%), metabolic syndrome (1.5%), gallstones (1.2%), inflammatory bowel syndrome (1.0%), pancreatitis (0.6%), hepatitis B (0.4%), Crohn's disease (0.1%), and hepatitis A (0.1%). Most patients with GI illness have had a history of smoking (34.4% vs. 21.9%, P < .001) or alcohol consumption (30.2% vs. 24.1%, P < .001). Patients with chronic GI illness had more average visits per year than those who did not have chronic GI illness (3.7 vs 2.2 visits per year, P < 0.001). Compared to patients without GI illness, patients with GI illness were older (Mean: 48.7 vs. 39.8 years, SD: 13.1 vs. 17.1, P < .001). CONCLUSION: Patients with chronic GI illness tended have more clinic visits, were more likely to have a comorbid history of smoking and alcohol consumption, and were older than those without GI illness. More education and preventative resources should be directed toward the most common GI illnesses such as GERD, chronic liver disease, and ulcers. Further evaluation of the low-income community is required to identify community level solutions and management strategies for chronic GI illness.

61 Background: Uninsured patients with low socioeconomic status are at higher risk for developing colorectal cancer. There is limited quantifiable data regarding risk factors and prevalence of colorectal cancer in this vulnerable population. The purpose of this study is to assess the risk factors for colorectal cancer in the low income and uninsured patient population across nine free clinics around Tampa Bay, Florida. Methods: An IRB-approved manually extracted retrospective query of several medical record systems from nine free clinics in the Tampa Bay area in 2017 revealed 1,836 (36.1%) of 5,076 total patients who are over 50 years old. Patient demographics, weight, smoking status, alcohol use, type 2 diabetes status, inflammatory bowel disease and colorectal cancer prevalence were also extracted and analyzed. Results: Among patients over 50, the majority of patients were female (n = 1073, 58.4%) and of Hispanic ethnicity (n = 752, 41.0%). Of the 1,349 patients who reported their smoking status, 213 (15.8%) were active smokers and 218 (16.2%) were past smokers, with a mean 16.3 (SD = 15.5) pack year history. Of the 1,124 patients who reported their history of alcohol consumption, 217 (19.3%) were current consumers and 40 (3.6%) were past consumers. The average BMI of patients over 50 years was 30.2 (SD = 6.9), with 558 (30.4%) cases of diabetes. Eleven patients (0.6%) had a history of inflammatory bowel disease. The prevalence of documented colorectal cancer in this sample was 0.6% (n = 11) in our sample population. Conclusions: There is a high prevalence of risk factors for colorectal cancer in this sample of uninsured patients but a lower reported prevalence of colorectal cancer compared to the general population. Additionally, many known risk factors for colorectal cancer, such as diet, physical activity, or family history, are not routinely documented by free clinics. As these clinics provide opportune points of primary care, this baseline data should prompt more attention to colorectal screening and risk factor modification in this vulnerable population.