Patient Non-adherence and Cancellations Are Higher for Screening Colonoscopy Compared with Surveillance Colonoscopy

Abstract

Patients undergoing colonoscopy for CRC screening are significantly less likely to attend their scheduled procedure within a year and have more procedure cancellations than those undergoing surveillance colonoscopy.

Adherence to Screening Colonoscopy: Can We Get Our Recommendations to Stick?

“…Prior consultation with a gastroenterologist did not affect colonoscopy adherence rates in this study [7], in conflict with prior reports indicating that physician visitation in the preceding year and procedure recommendation by a physician positively influenced rates of adherence to CRC screening [6,10]. This discrepancy may reflect a higher-risk population with increased rates of comorbid conditions in their study subjects [7].…”

“…Prior consultation with a gastroenterologist did not affect colonoscopy adherence rates in this study [7], in conflict with prior reports indicating that physician visitation in the preceding year and procedure recommendation by a physician positively influenced rates of adherence to CRC screening [6,10]. This discrepancy may reflect a higher-risk population with increased rates of comorbid conditions in their study subjects [7]. Furthermore, prior reports of a positive association between physician consultation and recommendation did not differentiate between specialist and primary care interaction, which may additionally account for this variation.…”

“…Health factors associated with non-adherence include multiple medical comorbidities and decreased primary care utilization [6]. Nevertheless, little is known about how adherence differs among patients who are undergoing surveillance colonoscopy indicated for a history of colorectal polyps or are undergoing screening colonoscopy.In this issue of Digestive Diseases and Sciences, Greenspan et al [7] report the results of a prospective study comparing rates of adherence to screening and surveillance colonoscopy in a population of 617 patients seeking care at an urban, tertiary medical center. Of multiple demographic factors studied in patients scheduled to undergo colonoscopy, patients scheduled for screening colonoscopy were significantly less likely to undergo their procedures than those scheduled for surveillance of adenomatous polyps (RR 5.42,).…”

“…The single factor associated with non-adherence and repeated procedure cancellations according to multivariable analysis, was indication for colonoscopy [7]. Although patients with a prior history of adenomatous polyps are at high risk of the development of adenomas or carcinoma (20-50 %) at subsequent surveillance colonoscopy, the risk of adenoma or carcinoma in asymptomatic patients undergoing screening colonoscopy can also be as high as 50 % [9].…”

“…In this issue of Digestive Diseases and Sciences, Greenspan et al [7] report the results of a prospective study comparing rates of adherence to screening and surveillance colonoscopy in a population of 617 patients seeking care at an urban, tertiary medical center. Of multiple demographic factors studied in patients scheduled to undergo colonoscopy, patients scheduled for screening colonoscopy were significantly less likely to undergo their procedures than those scheduled for surveillance of adenomatous polyps (RR 5.42, CI 2.74-10.75).…”