The COMPLETE-CRC Screening Initiative: Increasing Colonoscopy Completion After Positive Stool-Based Colorectal Cancer...

Area of Science:

• Colorectal Cancer Screening
• Public Health Interventions
• Quality Improvement in Healthcare

Background:

• Stool-based tests (SBTs) are increasingly utilized for colorectal cancer (CRC) screening.
• Suboptimal follow-up colonoscopy completion rates after positive SBT results present a significant challenge in CRC screening programs.

Purpose of the Study:

• To achieve a colonoscopy completion rate of ≥80% within six months of patient navigator contact for Ohio patients with positive SBTs.
• To identify factors influencing colonoscopy completion rates following positive SBT results.

Main Methods:

• A quality improvement study involving adults aged 45-75 with positive SBTs.
• Patient navigators contacted individuals who had not completed colonoscopy within 360 days via phone and/or MyChart.
• Colonoscopy completion within six months of navigator contact was the primary outcome; multivariable logistic regression analyzed associated factors.

Main Results:

• Of 2,548 patients with positive SBTs, 803 (31.5%) had not completed colonoscopy within 360 days.
• Patient outreach increased overall colonoscopy completion from 68.5% to 70.2%.
• Direct patient contact significantly improved completion rates (16.7% vs. 2.1% for indirect outreach; p<0.001), while older age was associated with lower completion (aOR 0.94; p=0.007).

Conclusions:

• Patient outreach initiatives positively impact colonoscopy completion following positive SBTs for CRC screening.
• Older age emerged as a significant factor associated with lower colonoscopy completion rates.
• Despite observed improvements, colonoscopy completion rates remain suboptimal, necessitating further optimization of CRC screening outreach strategies.