Saturday Screening Saves the Day!

Abstract

Introduction: Colorectal cancer (CRC) is the second leading cause of all cancer related deaths in the USA. Data from 2015 reveals that only 60-63% of adults 50 years and older had CRC screening. The National CRC Roundtable in coalition with the American College of Gastroenterology aimed to increase the rates of CRC screening to 80% by 2018. The use of colonoscopy for screening is dependent on the availability of the physician and the endoscopy center. The demand for colonoscopies is on the rise, and for many individuals weekdays may not be a reasonable time to undergo a procedure. The aim of this study was to evaluate the impact of improved access to colonoscopy by offering Saturday screenings as it relates to polyp detection and examine patient preference for weekend availability. Methods: During CRC awareness month (March 2018), gastroenterologists at Allegheny Health Network offered weekend screening colonoscopies at eight outpatient endoscopy centers. A survey outlining patient demographics and opinions on weekend screening were collected. Pathology results and adenoma detection rates (ADR) were collected one week after procedure completion. Results: A total of 80 patients underwent a colonoscopy, of which 59 (74%) were female and 67 (84%) were Caucasian. The majority of patients (87.5%) stated they were more likely to have a colonoscopy when offered on a weekend, with 74% of patients preferring bowel preparation on Friday followed by a Saturday procedure. In addition, 41 (51%) patients stated their main cause of delaying their screening colonoscopy was due to weekday employment. Pathology results revealed that 54 (67%) patients had at least one polyp, of which 35 (49%) had an adenoma (26 tubular, 8 sessile serrated, and 1 tubulovillous adenoma). Surveillance intervals also changed to 5, 3, and 1 year for 29, 9, and 4 patients, respectively. Conclusion: CRC is one of the most preventable cancers if caught early in its course. Our study highlights that many individuals delay their screening colonoscopy due to their inability to take off work. Weekend availability offers greater access to colonoscopy which can help prevent CRC. Treatment can cost up to $30,000 per patient once diagnosed. In turn, the cost of a screening colonoscopy is approximately $3,000. Saturday screenings provide a substantial impact in the mission to provide high quality care, improve patient experience, and decrease overall healthcare costs.2755_A Figure 1. Results from our 8-Question Survey from Saturday Screenings (N=80)2755_B Figure 2. Number of Patients with Adenomas2755_C Figure 3. Types of Adenomas Found