S3109 Improving Colorectal Cancer Screening Compliance With Resident Education

Abstract

INTRODUCTION: The incidence of CRC continues to increase at a rate of 2 1% per year in both men and women Screening for CRC improves prognosis by identifying early-stages for treatment, resulting in lower mortality Compliance rates for CRC screening have been low, and in optimized clinical settings, range from 50% to 70% Fecal Immunochemical Test (FIT) has advantages over colonoscopy as it does not require bowel preparation and anesthesia, and is an easier test to complete We hypothesize that CRC screening rates at our academic community hospital-affiliated clinic will improve by increasing resident education about FIT METHODS: We reviewed the charts of patients aged 50-75 seen by resident physicians at our clinic from June 1, 2019 to December 31, 2019 Patients who did not have a follow-up or comprehensive visit within the mentioned timeframe, had an active diagnosis of CRC or history of colorectal surgery, or with risk factors placing them at high lifetime risk for CRC were excluded Variables included patient age, gender, ethnicity, colonoscopy referral, FIT order, and reasons why CRC screening was not offered Resident physicians were given an educational presentation and an informational e-mail addressing self-reported barriers to ordering FIT for patients We then conducted a post-intervention chart review of patients aged 50-75 evaluated by residents from January 1, 2020 to March 31, 2020 and assessed the association of each variable with multivariate logistic regression RESULTS: There was no significant difference in age, gender, ethnicity and overall CRC screening rates between the pre- and post-intervention groups (Figure 1 ) There was a significant increase in FIT testing over colonoscopy (P=0 012, OR=2 10, 95% CI: 1 104-3 999) and in CRC screening rates in unscreened patients post-intervention (P=0 037, OR=1 55, 95% CI: 0 960-2 501) (Figure 2 ) There was a significant reduction in amount of resident physicians forgetting to screen patients (P=0 003, OR=4 44, 95% CI: 1 664-11 82) (Figure 3 ) CONCLUSION: Education improved the utilization of FIT testing over colonoscopy as well as the overall CRC screening rates in previously unscreened patients at our outpatient clinic Recent EHR data showed a decrease of approximately 86% in CRC screenings across the U S - presumably due to access disruptions due to COVID-19 However, our clinic after resident education shifted towards theutilization of FIT, and ultimately increasing our CRC screening rates for previously unscreened patients (Figure Presented)