286 Colonoscopy Outcome Similarities and Differences Between GI Providers and Non-GI Providers in Patients Who Undergo Colonoscopy Following a Positive Stool DNA Test

Abstract

INTRODUCTION: Previous stool DNA studies published aggregated results of colonoscopy outcome in patients who had a positive stool DNA test. In this study, we compare the outcome of colonoscopy based on the specialty of the provider who performed the procedure. METHODS: Review of charts of 1413 patients who had a positive stool DNA followed by documented colonoscopy was done. At total of 4 patients were excluded. Two patients were excluded because of finding of “other carcinoma” aside from adenocarcinoma while the other 2 were excluded because the provider type was unknown. Attention was given to the specialty of the provider performing the procedure. Patients were divided in 2 groups. Group 1 included patients who had their colonoscopy done by a GI provider while group 2 included patients who had their colonoscopy done but a Non-GI provider. Only the index lesion was recorded. Advanced adenoma was defined as an adenoma that is larger than 10 mm or had high risk features such as villous transformation or high grade dysplasia. Nonadvanced adenoma was defined as an adenoma that is smaller than 10 mm and had no high risk features. Statistical analysis with Chi-square and Fisher exact was done to compare the proportions. A P-value < 0.05 was considered to be statistically significant. RESULTS: Out of the 1409 patients included in the study, colonoscopy was performed by a gastroenterologist in 1180 (83.75%) of the patients, by a general surgeon in 198 (14.05%) of the patients, and by a primary care provider (internal medicine or family medicine) in 31 (2.2%) of the patients. The findings in group 1 and group 2 were compared. “adenocarcinoma” was found in 2.03% vs. 0% respectively (P = 0.02). “Advanced adenoma” was found in 23.98% vs. 22.27% respectively (P = 0.58). “10 mm adenoma” was found in 7.71% vs. 4.37% respectively (P = 0.07). Non advanced adenoma was found in 30% vs. 26.64% respectively (P = 0.31). Finally, no adenomas were found in 36.27% vs. 46.72% respectively (P = 0.003). CONCLUSION: This study shows similarities and differences in outcomes of colonoscopies in patients who have positive stool DNA test between high volume and low volume providers. GI providers and non GI providers had a difference in their findings of non advanced adenoma and adenocarcinoma. Further prospective studies are needed to validate these results.