P1750 - Characterizing Racial Disparities in Follow-Up Care After Open Access Colonoscopy

Alexandria Lenyo, MD¹, Lauren Van Buren, MD², Dayna Early, MD², Jean Wang, MD, PhD², Cassandra D.L. Fritz, MD, MPHS^2
1Vanderbilt University, Nashville, TN; ²Washington University in St. Louis, St. Louis, MO

Introduction: Open access colonoscopy (OAC) provides screening and diagnostic colonoscopies for those who are not office-established patients of a gastroenterologist. OAC has the potential to increase access to screening and surveillance, improving health equity. Non-attendance to open access endoscopies has been previously studied, but racial disparities in follow-up care after OAC has not been fully described.

Methods: We conducted a retrospective chart review of all OAC completed in 2019 at Barnes-Jewish Hospital (BJH), a large nonprofit hospital in St. Louis, MO. Demographic variables, personal and family history of colorectal cancer (CRC), Boston Bowel Prep Score (BBPS), endoscopic findings, pathology, and follow-up recommendations were recorded. Data was collected on follow-up care for patients who were recommended short follow-up intervals (≤ 3 years). Multivariable logistic regressions were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI).

Results: Of the 2627 patients scheduled for OAC in 2019, 543 (20.7%) patients received a follow-up recommendation of ≤ 3 years. The average age was 59.8 +/- 8.6 years. 252 (46%) were female, 234 (43.1%) self-identified as white, 309 (56.7%) identified as a racial minority, and 93.9% (290/309) of the minority patients identified as Black. Most (78.1%) patients had an adequate BBPS score (≥ 6). Only 45.5% (247/543) received the recommended follow-up care. 22.3% (121/543) of patients were given a ≤ 3-month follow-up interval, while 54.5% (296/543) were asked to repeat endoscopy at 3 years. Most patients (63.5%) had tubular adenomas, while only 27 (5%) had tubulovillous adenomas, 26 (4.8%) serrated lesions, and 6 patients (1.1%) had adenocarcinoma. Patients identifying as white were more likely to receive the recommended follow-up care than those identifying as a minority (52.1% vs 40.5%, p=0.007). Minority patients were found to be 38% less likely to receive the appropriate follow-up for any recommendation that was ≤ 3 years (controlling for BBPS, insurance type, age, pathology, family and personal history of CRC, and smoking history; OR = 0.62 95% CI 0.43 to 0.88).

Discussion: Minority patients undergoing OAC were less likely to receive the recommended follow-up colonoscopy after receiving a short follow-up interval (≤ 3 years). Although OAC has the potential to increase access to colonoscopies for patients and decrease disparities in CRC screening, including strategies for follow-up after OAC is critical.


Disclosures:


Alexandria Lenyo, MD¹, Lauren Van Buren, MD², Dayna Early, MD², Jean Wang, MD, PhD², Cassandra D.L. Fritz, MD, MPHS². P1750 - Characterizing Racial Disparities in Follow-Up Care After Open Access Colonoscopy, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.