Results of an Electronic Patient Survey to Determine Up-to-Date Colorectal Cancer Screening Status and Identify High-Risk Individuals

Abstract

Introduction: The incidence and mortality of colorectal cancer CRC has declined dramatically, due to improved screening which prevent and detect CRC in its earliest stages. However, screening rates continue to be suboptimal, especially in high-risk individuals. This disparity is partially attributable to the difficulty in identifying high-risk individuals who require more intensive screening. Methods: We devised a one-page IRB-approved patient survey that determined if a patient was up-to-date on CRC screening based on 2016 USPSTF guidelines. The survey was administered to Penn State Health employees ≥ 40 years via the RedCap online platform through the Department of Human Resources. The survey anonymously collected data on demographic information and CRC screening tests. The survey also included a checklist of five questions including a previously validated hereditary CRC risk assessment tool to help identify high-risk patients. Associations between demographic/risk factors and up-to-date screening status were examined using Fisher’s exact test for categorical variables and Wilcoxon Rank-Sum test for quantitative variables. Results: Questionnaires were administered to 6,188 employees, with a response rate of 45%. 2,638 met inclusion criteria and were included in statistical analysis. Eighty percent of respondents were females. For respondents ≥ 50 years, 81% reported up-to-date CRC screening; 76% of 50-59 year olds, 92% of 60-69 year old, and 100% of ≥ 70 year olds. There was no difference in screening rates by gender or race. Colonoscopy was the most common screening method (78%). Thirty-three percent of all participants self-identified as high-risk; 77.7% reporting up-to-date CRC screening. Twenty-five percent of participants aged 40-49 self-identified as high-risk, but only 46% reported up-to-date screening. Conclusion: Our short electronic questionnaire championed by our Human Resources Department was a novel and efficient way to evaluate a large number of patients to determine CRC screening rates and identify high-risk individuals. It utilized familiar technology, easily administered and completed, as evidenced by a high response rate. Our survey increased CRC screening awareness, identified and measured screening rates in younger, “at-risk,” individuals. Our institution met the CRC screening target of “80% by 2018.” This tool could be used by any large employer to measure their CRC screening rates.