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Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Pathways to colonoscopy in the South: seeds of health disparities
Barbara A Curbow1, Amy B Dailey, Evelyn C King-Marshall
1At the time of the study, Barbara A. Curbow, Evelyn C. King-Marshall, and Tracy E. Barnett were with the Department of Behavioral Science and Community Health, University of Florida, Gainesville. Jessica R. Schumacher was with the Department of Health Services Research, Management & Policy, Gainesville. Shahnaz Sultan was with the North Florida/South Georgia Veterans Affairs Medical Center, Department of Medicine, Gainesville. Thomas J. George Jr was with the Department of Medicine, University of Florida, Gainesville. Amy B. Dailey was with the Department of Health Sciences, Gettysburg College, Gettysburg, PA.
Objectives:
We aimed to highlight sociodemographic differences in how patients access colonoscopy.
Methods:
We invited all eligible patients (n = 2500) from 2 academy-affiliated colonoscopy centers in Alachua County, Florida (1 free standing, 1 hospital based), to participate in a precolonoscopy survey (September 2011-October 2013); patients agreeing to participate (n = 1841, response rate = 73.6%) received a $5.00 gift card.
Results:
We found sociodemographic differences in referral pathway, costs, and reasons associated with obtaining the procedure. Patients with the ideal pathway (referred by their regular doctor for age-appropriate screening) were more likely to be Black (compared with other minorities), male, high income, employed, and older. Having the colonoscopy because of symptoms was associated with being female, younger, and having lower income. We found significant differences for 1 previously underestimated barrier, having a spouse to accompany the patient to the procedure.
Conclusions:
Patients' facilitators and barriers to colonoscopy differed by sociodemographics in our study, which implies that interventions based on a single facilitator will not be effective for all subgroups of a population.
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