Su1476 Evaluating the Impact of Health Literacy on Knowledge, Attitudes, and Beliefs Toward Colorectal Cancer (CRC) and CRC Screening in Veterans. The Value Study: Veterans as Leaders in Understanding and Education

Abstract

resection, complication rates, length of hospital stay and accessories used. Using standardised costs, the overall cost of each procedure was estimated. Results: ESD was performed on 104 lesions and EMR was performed on 184. Patients were of similar ages. Mean lesion size was similar in the ESD (37.5mm) and EMR (37.3mm) cohorts (p 0.6). Significantly more lesions were in the right colon in the EMR cohort (62% v 34%, p 0.001). There was a higher prevalence of significant comorbidity in the EMR group (22.8% v 13.5%, p 0.05). Complication rates between the groups were similar. All perforations were recognised during the resection, closed endoscopically and none required surgery. Lesions undergoing ESD had more advanced pathology with significantly higher rates (all P values 0.001) of Kudo pit pattern type V (59.2% v 2.2%), non-granular morphology (44% v 35%), submucosal fibrosis (52.9% v 20.7%) and submucosal invasion (20.2% v 4.9%). There was also a higher rate of successful resection (100% v 95%, p 0.03), larger size of specimen (39.5mm v 20.2mm, p 0.001) and lower number of pieces required to achieve resection (1.1 v 4.5, p 0.001) in the ESD cohort.The EMR group had significantly lower (all p 0.001) duration of resection (22 mins v 95 mins), mean length of post procedure hospitalisation (0.1 v 4.1 nights), average procedural cost per patient ($1370 v $2667) and total cost per patient ($1434 v $5812). Conclusions: ESD is associated with higher technical success rates than EMR, even in those with more advanced pathology. This benefit needs to be weighed up against the significant savings in time and lower costs associated with EMR. Ongoing follow up is being undertaken to assess the medium and long term outcomes of these two advanced endoscopic resection techniques.