Impact of Primary Language on Early Repeat Screening Colonoscopy

Area of Science:

• Gastroenterology
• Public Health
• Health Disparities

Background:

• Repeat colonoscopy is recommended after inadequate bowel preparation to prevent missed advanced neoplasia.
• The impact of primary language on the risk of early repeat colonoscopy is not well understood.
• Investigating language as a factor in colonoscopy follow-up is crucial for equitable healthcare.

Purpose of the Study:

• To compare the rates of repeat colonoscopy within one year between patients whose primary language is not English (NEPL) and English-speaking patients (EPL).
• To assess the association between primary language and the detection of colorectal polyps and cancer on repeat colonoscopy.

Main Methods:

• Utilized the TriNetX Research Network database to analyze screening colonoscopy data.
• Employed propensity score matching (PSM) to control for confounding factors related to bowel preparation quality.
• Calculated odds ratios (OR) with 95% confidence intervals (CI) to compare outcomes between NEPL and EPL cohorts.

Main Results:

• Non-English primary language patients (NEPL) showed higher odds of undergoing repeat colonoscopy within one year compared to English primary language patients (EPL) (OR: 1.49).
• The rate of polyp detection on repeat colonoscopy was similar between the two groups.
• NEPL patients had significantly higher odds of colorectal cancer (CRC) detection on repeat colonoscopy (OR: 1.4).

Conclusions:

• Patients with a primary language other than English have an increased likelihood of requiring early repeat colonoscopies.
• While infrequent, colorectal cancer detection was higher in the NEPL group, highlighting potential disparities.
• Language-tailored interventions focusing on improving bowel preparation could reduce repeat procedures and enhance CRC screening efficacy for diverse populations.