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Endoscopic Procedures II: Colonoscopy01:25

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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation01:30

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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Updated: Feb 28, 2026

Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
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Rates and Timing of Follow-up Colonoscopy After a Positive Stool-Based Test in an Integrated Health System.

Christina P Wang1, Ankit M Shah2, Matthew Y Zhao2

  • 1Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, USA. Christina.Wang@mountsinai.org.

Journal of General Internal Medicine
|February 26, 2026
PubMed
Summary
This summary is machine-generated.

Timely follow-up colonoscopy completion after a positive stool test is suboptimal, especially in older, sicker patients. System-level interventions are needed to overcome barriers like missed appointments and cancellations for colorectal cancer screening.

Keywords:
ColonoscopyColorectal neoplasmsEarly detection of cancerOccult blood

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Area of Science:

  • Gastroenterology
  • Public Health
  • Health Services Research

Background:

  • Completion rates for follow-up colonoscopy after positive stool tests vary significantly across healthcare settings.
  • Delayed colonoscopies (over 6 months post-positive stool test) are linked to poorer colorectal cancer outcomes.

Purpose of the Study:

  • To evaluate the rates of timely follow-up colonoscopy completion after a positive stool test within an urban health system.
  • To identify factors associated with timely colonoscopy and barriers to completion.

Main Methods:

  • Retrospective study of 701 patients (aged 45-75) with positive stool tests.
  • Analysis of timely (≤180 days) and point-specific (90, 365 days) colonoscopy completion rates.
  • Multivariable Cox models and Pareto analysis to identify predictors and barriers.

Main Results:

  • Only 59.6% of patients completed timely follow-up colonoscopy (≤180 days).
  • Patient outreach improved timely completion by 52%, while Direct Access patients were less likely to complete it.
  • Key barriers included missed gastroenterology appointments, patient refusal, and procedure cancellations/no-shows.

Conclusions:

  • The rate of timely colonoscopy completion in this older, comorbid population is suboptimal.
  • System-level factors significantly influence timely colonoscopy completion.
  • Identifying and addressing barriers through interventions can improve timely follow-up and potentially colorectal cancer outcomes.