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

Area of Science:

• Gastroenterology
• Preventive Medicine
• Public Health

Background:

• A significant portion of the population does not adhere to recommended colorectal cancer (CRC) screening colonoscopies.
• Low adherence rates can impede the effectiveness of CRC screening programs.

Purpose of the Study:

• To identify demographic and clinical factors linked to non-adherence and multiple cancellations for colonoscopies.
• To analyze these factors within a population undergoing CRC screening versus adenomatous polyp surveillance.

Main Methods:

• An observational cohort study was conducted with 617 patients scheduled for colonoscopy.
• Data was collected from January 2012 to September 2012 at an academic tertiary care center.
• Patients were undergoing colonoscopy for either CRC screening or adenomatous polyp surveillance.

Main Results:

• 10.7% of patients were non-adherent to their scheduled colonoscopy within one year.
• Patients undergoing colonoscopy for CRC screening had a significantly higher relative risk (5.42) of non-adherence compared to surveillance patients (16.7% vs. 3.5%).
• Screening indication was associated with increased non-adherence (OR 12.69) and multiple cancellations (OR 2.33) in regression analysis.

Conclusions:

• Patients scheduled for colorectal cancer screening colonoscopies are less likely to attend than those for surveillance.
• Higher rates of non-adherence and procedure cancellations are observed in the CRC screening group.
• These findings highlight a need to address barriers to colonoscopy adherence in screening populations.