S3118 Patient Language Does Not Affect Access to Colonoscopy but Did Reduce Quality of Prep at an Academic Medical Center

Abstract

INTRODUCTION: Disparities in colorectal cancer (CRC) screening continues to exist for minority groups in the US. Some studies have suggested that improved communication between patients and providers leads to increased rates of CRC screening. In this study, we examined whether language plays a role in scheduling colonoscopies and or the quality of colonoscopy preparation in a rural based primary care setting that serves as a safety net for Central Virginia. METHODS: We performed a single center review of all colonoscopy case requests (n = 1266) from an academic primary care clinic from March 2018 to February 2020. We categorized patients as English (n = 1062) or non-English speaking (n = 204) and then evaluated whether patients were scheduled for procedure, the time from request to scheduled case, whether the case was completed, and the quality of prep. The quality of the prep was categorized as adequate or inadequate from the endoscopy report. Cases that were not scheduled were grouped into reasons for why they were not scheduled. Statistical comparisons were performed using Chi-square test between the two groups. RESULTS: There were 1266 case requests and 711 were scheduled (56%). For English speakers there were 589 scheduled cases (589/1062, 55%) and 465 completed (465/589, 79%). For non-English speakers there were 122 scheduled cases (122/204, 60%) and 105 completed (105/122, 86%). The average time to completed case was 82 days for English speakers and 80 days for non-English speakers. The quality of prep for English speakers was adequate in 410 cases (410/465, 88%). The quality of prep for non-English speakers was adequate in 85 cases (85/105, 81%). When English speaking patients were compared to non-English speaking patients there was reduced quality of prep (P = 0.04), but not scheduling (P = 0.25) or completed cases (P = 0.07) (Table 1). CONCLUSION: Studies have suggested that improved communication between patient and provider may lead to increased CRC screening rates. Our study suggests that the language a patient speaks may play a role in prep adequacy, with fewer adequate preps found in non-English speakers. Patient language does not seem to affect scheduling, completed cases or time to completed case. Analysis of the reasons for not scheduling a colonoscopy showed that the most common reason was the inability to be reached by phone (Table 2). Further studies are needed to evaluate whether patient-provider language plays a role in access to colonoscopy and prep adequacy.Table 1.: Scheduled Colonoscopies, Completed Cases, Days to Complete Case, and Quality of Prep in English and Non-English Speaking PatientsTable 2.: Reasons for Unsuccessful Scheduling of Colonoscopies in All Patients