Utility Of Colonoscopy Research Articles

Inadequate Utilization of Diagnostic Colonoscopy Following Abnormal FIT Results in an Integrated Safety-Net System.

The effectiveness of stool-based colorectal cancer (CRC) screening is contingent on colonoscopy completion in patients with an abnormal fecal immunochemical test (FIT). Understanding system and patient factors affecting follow-up of abnormal screening tests is essential to optimize care for high-risk cohorts. This retrospective cohort study was conducted in an integrated safety-net system comprised of 11 primary-care clinics and one Gastroenterology referral unit and included patients 50-75 years, with a positive FIT between April 2012 and February 2015. Of the 2,238 patients identified, 1,245 (55.6%) completed their colonoscopy within 1-year of the positive FIT. The median time from positive FIT to colonoscopy was 184 days (interquartile range 140-232). Of the 13% of FIT positive patients not referred to gastroenterology, 49% lacked documentation addressing their abnormal result or counseling on the increased risk of CRC. Of the patients referred but who missed their appointments, 62% lacked documentation following up on the abnormal result in the absence of a completed colonoscopy. FIT positive patients never referred to gastroenterology or who missed their appointment after referrals were more likely to have comorbid conditions and documented illicit substance use compared with patients who completed a colonoscopy. Despite access to colonoscopy and a shared electronic health record system, colonoscopy completion after an abnormal FIT is inadequate within this safety-net system. Inadequate follow-up is in part explained by inappropriate screening, but there is an absence of clear documentation and systematic workflow within both primary care and GI specialty care addressing abnormal FIT results.

516P Utility of colonoscopy in diagnosing familial adenomatous polyposis (FAP) among patients (pts) with desmoid tumors (DT)

516P Utility of colonoscopy in diagnosing familial adenomatous polyposis (FAP) among patients (pts) with desmoid tumors (DT)

516P Utility of colonoscopy in diagnosing familial adenomatous polyposis (FAP) among patients (pts) with desmoid tumors (DT)

516P Utility of colonoscopy in diagnosing familial adenomatous polyposis (FAP) among patients (pts) with desmoid tumors (DT)

A Comprehensive Intervention to Enhance Inpatient Colon Preparation Quality and Efficacy for Colonoscopy: 2016 ACG Presidential Poster Award

Introduction: Safety, accuracy and utility of colonoscopy requires adequate colon preparation. This is particularly important for inpatients undergoing colonoscopy for acute diagnostic or therapeutic indications. Inadequate inpatient colon preparation has been associated with longer hospital length of stay and increased hospital costs. We report implementation of a quality improvement intervention to improve the quality of inpatient colon preparations. Methods: Reports from inpatient colonoscopies performed over 12 months were reviewed to assess baseline colon preparation quality as determined by the Boston Bowel Prep Score (BBPS). A comprehensive intervention to improve colon preparation quality was subsequently developed. The intervention had multiple, simultaneously-implemented, components including: Standardized, EMR-based, colonoscopy preparation order set (Figure 1); Automated EMR alerts to prompt nursing assessment of colon preparation progress; Standardized nursing charting processes for tracking progress of colon preparation (Figure 2); Standardized education for nursing staff and ordering providers on importance of adequate colon preparation, assessment of colon preparation quality, and use of the above processes; Use of standardized patient education materials. A 10-week pilot implementation of the intervention was undertaken and postintervention colon preparation quality assessed.Figure 1Figure 2Results: 239 inpatient colonoscopies were performed in the preintervention assessment period. Mean preintervention total BBPS was 6.7 (2.3 in left colon, 2.3 in transverse colon, 2.1 in right colon) and 22.5% of patients (n=54) had inadequate colon preparation (total BPPS < 6 or BPPS < 2 in any segment). 10 weeks after pilot implementation of the quality improvement intervention, colon preparation quality data was available on 31 patients. Of these, 6.5% of patients (n=2) had inadequate colon preparation. Mean postintervention total BBPS was 7.6 (2.6 in left colon, 2.7 in transverse colon, 2.3 in right colon), representing a 13.4% improvement in total BPPS following implementation of the quality improvement intervention. Conclusion: Use of a comprehensive colon preparation quality intervention resulted in improved inpatient colon preparation quality in this pilot implementation. The intervention is being implemented hospital-wide. The EMR-based processes and patient education materials are being refined. Data collection on colon preparation quality, hospital length of stay, and hospital costs is ongoing.

Colonic polyp histopathology and location in a community-based sample of older adults.

BackgroundColorectal cancer and its precursors are highly prevalent in developed countries. Estimates in the available literature for prevalence of right-sided-only lesions vary between 20.5 and 48.1 %, with association with female gender and advancing age. Since the original polyp studies, premalignant potential of sessile serrated adenomas has been described and screening utilization of colonoscopy in men, women, and older adults has increased. This study describes the histopathology and distribution of colorectal polyps by age and gender in the post-screening era.MethodsA registry of biopsies performed during colonoscopy for adults aged 50+ years in 2002-2012 was created using pathology reports from an independent, regional laboratory. Age, histopathology, and polyp location(s) were included. A subgroup analysis was performed for sessile serrated adenomas for 2007-2012. Distributions of histopathology and polyp location were described by age and gender. Statistical comparisons are made using chi-square tests.Results13,881 patients (55.5 % male, 44.5 % female), aged 50-95 years (median = 62) were identified. Most patients (59.9 %) had adenomas. Single and multiple adenomas were more common in men than women (57.7 % vs 42.3 %, p < .0001 and 62.2 % vs 37.8 %, p < .001), and with advancing age (60.4 % for ages 50- < 60, 63.4 % for ages 60- < 70, 65 % for ages 70- < 80, and 68.9 % for ages >80). Villous adenomas (n = 545; 3.6 %), dysplasia (n = 49; 0.4 %), and invasive carcinoma (n = 22; 0.2 %) were rare. Sessile serrated adenomas were uncommon (n = 417, 4.5 %), with greater prevalence in women than men (5.1 % vs 4 %, p = 0.02). Patients aged 70- < 80 were more likely to have multiple polyps than those aged 50- < 60 (OR 1.17, 95 % CI 1.03–1.32, p = 0.018 and OR 1.27, 95 % CI 1.10–1.46, p = .001). Most polyps were from ascending and/or transverse colon (n = 8095; 58.3 %). When location was stratified by sex only, men had more polyps than women at each location except the sigmoid and rectum. Further stratification by age of location and sex revealed statistically significant differences (age 50- < 60, p < .0001, age 60- < 70, p = .0227, age 70- < 80, p = .0298, age 80+, p = .0018).ConclusionsThis large community-based sample contributes to understanding of colonic neoplasia. The high prevalence of right and transverse lesions supports ongoing use of colonoscopy over sigmoidoscopy for screening examinations.

Sa1132 Limited Utilization of Diagnostic Colonoscopy Following Positive FIT in a Safety-Net System

Sa1132 Limited Utilization of Diagnostic Colonoscopy Following Positive FIT in a Safety-Net System

Colorectal cancer mortality reduction is associated with having at least 1 colonoscopy within the previous 10 years among a population-wide cohort of screening age

Colonoscopy has been demonstrated to be effective in colorectal cancer (CRC) mortality reduction, although current screening guidelines have yet to be evaluated. We assessed the protective benefit of colonoscopy within the previous 10 years and whether this effect is maintained with age. We used administrative data to compare risk of CRC death (CCD) across colonoscopy utilization among a population-wide cohort comprising individuals aged 60 to 80 years (N= 1,509,423). Baseline and time-dependent colonoscopy exposure models were assessed in the context of competing "other causes of death" (OCDs). Cumulative incidence of CCD and OCD across colonoscopy exposure, over follow-up, was estimated. Relative hazards were computed by age strata (60-69 years, 70-74 years, 75+ years) and proximal and distal cancer subsites. At least 1 colonoscopy during 10 years before baseline was estimated to provide a 51% reduced hazard of CCD (hazard ratio [HR] 0.49; 95% confidence interval [CI], 0.45-0.54) over the following 8 years. When colonoscopy was modeled as a time-dependent covariate, the risk of CCD was further diminished (multivariable-adjusted HR 0.36; 95% CI, 0.33-0.38). Stratified analyses suggested moderately attenuated CCD risk reduction among the oldest age group; however, consideration of OCDs suggest that this is related to competing risks. CCD risk reduction related to colonoscopy was lower for proximal cancers. Colonoscopy within the previous 10 years provides substantial protective benefit for average-risk individuals over 60 years. CCD risk reduction may be maintained well beyond 74 years, a common upper age limit recommended by screening guidelines.

Preliminary Experience Using Full-Spectrum Endoscopy for Colorectal Cancer Screening: Matched Case Controlled Study.

Background/Aim. High-quality colonoscopy is needed to reduce the morbidity and mortality of colorectal cancer. Full-spectrum endoscopy (FUSE) has recently shown potential in improving adenoma detection during colonoscopy. This study aimed to evaluate the feasibility and utility of FUSE colonoscopy. Methods. From April 2015 to February 2016, 130 patients underwent FUSE colonoscopy for screening at a tertiary cancer center. Cecal intubation rate (CIR), procedure time, polyp/adenoma detection rate (PDR/ADR), and mean number of adenomas per colonoscopy (APC) were compared in matched-control patients (n = 260) who underwent standard colonoscopy (SC). Accordingly, endoscopists subjectively evaluated the utility of FUSE colonoscopy. Results. The CIR of FUSE colonoscopy was 94.6%. Cecal intubation time (8.8 min versus 5.1 min, P < 0.001) and total procedure time (21.6 min versus 17.3 min, P < 0.001) in the FUSE group were significantly longer than those in the SC group. PDR (68.3 versus 71.2%, P = 0.567), ADR (63.4% versus 58.5%, P = 0.355), and APC (1.4 versus 1.4, P = 0.917) were not significantly different between the two groups. The wide view of FUSE colonoscopy was superior to that of SC based on the questionnaires. Conclusions. FUSE colonoscopy did not demonstrate superiority to SC in a clinical setting.

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria.

IntroductionColorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria.MethodsThis is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 –July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria.ResultsA total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%). The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis.ConclusionThe study supports the present wisdom that polyps are clearly less prevalent in our environment when compared to the Western world. The increased prevalence with advancing age, in male subjects and of left sided lesions, is also in keeping with previous results from our environment. A case is also advanced for the increased deployment of endoscopy as a tool for the detection of these polyps and ultimately, the reduction of colorectal cancer in our population.

Sex-Based Disparities in the Use and Results of Gastrointestinal Procedures for Workup of Anemia

Background: Iron deficiency is a common cause of anemia, and etiologies differ by sex. Endoscopic procedures are often utilized to search for a source of gastrointestinal blood loss in patients with iron deficiency, but sex-based differences in patterns of workup have not been well characterized. Methods: We performed a retrospective review of all patients at Mayo Clinic who underwent esophagogastroduodenoscopy (EGD), colonoscopy, or both between July 1, 2014 and June 30, 2015 for an indication of “anemia” or “iron deficiency anemia” and analyzed the data for evidence of sex-based differences in procedure outcomes. Results: 999 procedures were performed; 455 (46%) procedures were performed on men and 544 (54%) on women. Median age was 68 years in men (range 19-94) and 64 years in women (range 18-94), P<0.01. 365 (37%) procedures identified a probable benign source of bleeding, 54 (5%) identified a probable malignant source, and 580 (58%) had no findings consistent with a bleeding source. Procedures performed on men were more likely to identify a source of bleeding (48% versus 37%, P<0.01), primarily EGDs which were significantly more likely to identify a bleeding source in men (59% versus 37%, P<0.01). Conclusion: There are sex-based variations in the utilization and findings of EGD and colonoscopy used for workup of anemia. A source of bleeding is more likely to be identified in men, particularly in the case of EGD. Clinicians should be made aware of these variations and quality improvement programs may be helpful to reduce non-clinically indicated practice variations.

There Is No Role for Colonoscopy after Diverticulitis among Asian Patients Less than 50 Years of Age

Background: Colonoscopy is advocated following acute diverticulitis to ensure that malignancy is not missed. In an Asian population, diverticulitis is more common in the right colon and in younger patients. The purpose of this study is to examine the utility of colonoscopy amongst Asian patients <50 years of age who have had colonic diverticulitis. Methods: A retrospective review of all patients aged 50 years and under who were treated for colonic diverticulitis between 2012 and 2014 was performed. All patients were advised to undergo a colonoscopy when the diverticulitis had settled, and findings at colonoscopy were recorded. Results: Fifty-five patients aged <50 years had acute diverticulitis. Forty-eight (87.3%) had right-sided diverticulitis. Amongst them, 45 (93.8%) had Hinchey 1a, 1b or 2 diverticulitis, while none had Hinchey 4 diverticulitis. Excluding the only patient that underwent a colonic resection, 27 (50.0%) patients returned for a colonoscopy. None of these patients were found to have colorectal cancer or an advanced adenoma. Six (11.1%) of them had adenomas with low-grade dysplasia. Conclusion: Right-sided diverticulitis is more common in the young Asian population. Most patients can be conservatively treated. Follow-up colonoscopy may not be required in these patients.

Improving the utility of colonoscopy: Recent advances in practice.

Colonoscopy is a frequently performed diagnostic and therapeutic test and the primary screening tool in several nationalized bowel cancer screening programs. There has been a considerable focus on maximizing the utility of colonoscopy. This has occurred in four key areas: Optimizing patient selection to reduce unnecessary or low yield colonoscopy has offered cost-benefit improvements in population screening. Improving quality assurance, through the development of widely accepted quality metrics for use in individual practice and the research setting, has offered measurable improvements in colonoscopic yield. Significant improvements have been demonstrated in colonoscopic technique, from the administration of preparation to the techniques employed during withdrawal of the colonoscope. Improved techniques to avoid post-procedural complications have also been developed-further maximizing the utility of colonoscopy. The aim of this review is to summarize the recent evidence-based advances in colonoscopic practice that contribute to the optimal practice of colonoscopy.

Utility of Colonoscopy to Exclude Underlying Malignant Polyps After Resolution of Uncomplicated Diverticulitis

intervention, or monitoring.3 After resolution of an episode of diverticulitis, the standard of care is to perform a colonoscopy to exclude diagnoses that mimic diverticulitis—notably, colorectal cancer. This recommendation arose during a time when the diagnosis rested on clinical suspicion and radio­ graphic imaging with barium.4 Computed tomog­ raphy, with a substantially higher sensitivity than barium enema5 at diagnosing cancer and other ab­ dominal pathologic conditions, is now the primary modality used to define complicated diverticulitis, with low interobserver variability and a sensitivity and specificity approaching 99%.6 Computed tomo­ graphic findings in complicated diverticulitis in­ clude abscess, fistula, stricture, extensive stranding, obstruction, or air (ie, perforation); colonic wall thickening and mass lesions are concerning radio­ logic features for neoplasia. The current Clinical Guideline Task Force of the American Society of Colon and Rectal Surgeons recommends that “after resolution of acute diverticu­ litis, perform colonoscopy in 6 to 8 weeks following resolution, to confirm diagnosis; if this is first epi­ sode or recent colonoscopy has not been done” Utility of Colonoscopy to Exclude Underlying Malignant Polyps After Resolution of Uncomplicated Diverticulitis

836 Racial and Ethnic Disparities in Colonoscopy Utilization Among Individuals With a Family History of Colorectal Cancer

836 Racial and Ethnic Disparities in Colonoscopy Utilization Among Individuals With a Family History of Colorectal Cancer

Sa1040 The Impact of the Fecal Immunochemical Test on Colonoscopy Utilization and Resources at a Canadian Regional Screening Centre

Sa1040 The Impact of the Fecal Immunochemical Test on Colonoscopy Utilization and Resources at a Canadian Regional Screening Centre

Association between socioeconomic and demographic characteristics and utilization of colonoscopy in the EPIC-Heidelberg cohort.

We aimed to describe the utilization of colonoscopy and its association with sociodemographic characteristics within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort study. We included 15 014 study participants (43% men) of the EPIC-Heidelberg cohort recruited between 1994 and 1998. At baseline recruitment, as well as in the 3-yearly follow-up surveys, study participants completed questionnaires on lifestyle, socioeconomic background variables, health status, and use of medications and medical services, including colonoscopy examinations. The present analyses focused on participants who completed the question on colonoscopy examination in all follow-up rounds. Our results show that by the end of the fourth follow-up round, more than half of all participants of the EPIC-Heidelberg cohort had had a colonoscopy. Colonoscopy was associated with some socioeconomic and demographic characteristics: a positive association with vocational training level as well as overall socioeconomic status level [International Standard Classification of Education (ISCED) classification]. A negative association was found for household size and employment status. Colonoscopy usage increased steeply within the subgroup of participants older than 55 years of age and decreased again within the subgroup of participants older than 75 years of age. Organized colorectal cancer screening should include a written invitation system, to overcome the problem of sociodemographic-related differential awareness of and attendance at colonoscopy examinations. Also, the high proportion of prescreened individuals should be taken into account to avoid unnecessary re-examinations.

Quality monitoring in colonoscopy: Time to act.

Colonoscopy is the gold standard test for colorectal cancer screening. The primary advantage of colonoscopy as opposed to other screening modalities is the ability to provide therapy by removal of precancerous lesions at the time of detection. However, colonoscopy may miss clinically important neoplastic polyps. The value of colonoscopy in reducing incidence of colorectal cancer is dependent on many factors including, the patient, provider, and facility level. A high quality examination includes adequate bowel preparation, optimal colonoscopy technique, meticulous inspection during withdrawal, identification of subtle flat lesions, and complete polypectomy. Considerable variation among institutions and endoscopists has been reported in the literature. In attempt to diminish this disparity, various approaches have been advocated to improve the quality of colonoscopy. The overall impact of these interventions is not yet well defined. Implementing optimal education and training and subsequently analyzing the impact of these endeavors in improvement of quality will be essential to augment the utility of colonoscopy for the prevention of colorectal cancer.

Predicting the risk of recurrent adenoma and incident colorectal cancer based on findings of the baseline colonoscopy.

Objectives:The decision tree underlying current practice guidelines for post polypectomy surveillance relies on risk stratification based on predictive attributes gleaned from adenomas removed on screening colonoscopy examination. Our primary aim was to estimate the magnitude of association between baseline adenoma attributes and the risk of adenoma recurrence and invasive colorectal adenocarcinoma (CRC). Our secondary aims were to estimate the adenoma detection rate (ADR) of surveillance compared with screening colonoscopies and describe time trends in preventive colonoscopy utilization.Methods:We used prospective analyses of retrospectively collected clinical data from electronic health records. A cohort of primary care patients eligible for colorectal cancer screening was assembled encompassing 110,452 subjects, of which 3,300 had adenomas removed on screening examination. Of those patients who had a follow-up surveillance colonoscopy (defined as a patient with a documented adenoma on prior colonoscopy) recorded during the study period, 537 had a recurrent adenoma.Results:Of those recurrent adenomas, 354 had a high-risk attributes. High-risk attributes were described at >3 adenomas, at least one adenoma >10 mm in size, high-grade dysplasia, or villous features. The risk of developing invasive CRC among post polypectomy patients was significantly higher if the baseline adenomas displayed any of the following attributes: more numerous than 3 (4.3-fold higher risk, 95% confidence interval (CI) low, high 1.4, 12.9), larger than 10 mm in size (5.2-fold higher risk, 95% CI low, high 1.8, 15.1), high-grade dysplasia (13.2-fold risk, 95% CI low, high 2.8, 62.1), or villous features (7.4-fold higher risk, 95% CI low, high 2.5, 21.5). These attributes combined added a net value of 22.8% to the probability of correctly predicting CRC. There was a threefold increase in surveillance utilization relative to screening from 2005 to 2011. The ADR of surveillance (34.1%) was 1.5-fold higher than that of screening (23.1%).Conclusions:These results emphasize the need to mitigate excessive risk by performing timely surveillance colonoscopies in patients with baseline adenomas displaying high-risk attributes as recommended in practice guidelines.

Estimating screening test utilization using electronic health records data.

Background:Electronic health records (EHRs) are increasingly used by medical providers and offer a wide-reaching source of information on utilization of preventive services. Numerous measures used for quality assessment and public reporting are estimated based on EHR data. However, sources of error and misclassification can lead to over- or underestimation of true utilization rates. EHR-derived measures of screening test use are subject to error due to misclassification of screening and diagnostic tests. The implications of this misclassification for EHR-based screening utilization estimates have not been well explored.Objectives:We calculated the bias in estimates of screening test utilization associated with several published EHR-based algorithms for identifying screening colonoscopies and propose two simple methods to correct this bias. We apply these corrections to obtain adjusted estimates of screening colonoscopy utilization using EHR data from Group Health, an integrated health care system in Washington state.Findings:The bias in screening colonoscopy utilization estimates ranged from an underestimation of 3 percentage points to an overestimation of 12 percentage points across classification methods. If the operating characteristics of the classification method are known or if a statistical model that returns predicted probabilities of screening indication is applied in the population of interest, this information can be used to obtain unbiased estimates through simple corrections to the utilization rates with little loss of precision. When applied to data on colonoscopies received at Group Health, we found that an unadjusted estimate was 4 percentage points higher than our adjusted estimate.Discussion:Error in classification of tests as screening when using EHR data to study screening utilization should be accounted for in order to eliminate bias and prevent spurious findings.

Abstract B79: Colonoscopy screening in a community sample of African Americans

Abstract Background: Colonoscopy is an efficacious strategy for reducing morbidity and mortality from colorectal cancer. Low utilization of colonoscopy contributes to racial disparities in colorectal cancer outcomes. Predictors of colonoscopy have been examined in clinical samples, but decisions about cancer screening are made in a multidimensional context that includes social, psychological, socioeconomic factors. Evaluating the association between colonoscopy utilization and multidimensional factors in a community-based sample is needed to understand how screening decisions are made in a community context. Objectives: To evaluate the independent associations between social, psychological, socioeconomic, and clinical factors on colonoscopy use in a community-based sample of urban African American adults. Methods: Participants were 236 African American men and women ages 50-75 who were enrolled in a community-based navigation program for cancer control. Data on colonoscopy use and socioeconomic (e.g., income), clinical (e.g., provider communication about colonoscopy), social (e.g., neighborhood satisfaction), and psychological factors (e.g., self-efficacy) were obtained by self-report during a baseline telephone interview that was completed prior to navigation. Results: Overall, 58% of participants reported having a colonoscopy. Factors having significant independent associations with colonoscopy included older age (OR=1.15, 95% CI=1.07, 1.24, p=0.0002), greater neighborhood satisfaction (OR=1.86, 95% CI=1.05, 3.30, p=0.03), physician recommendation (OR=12.69, 95% CI=5.33, 30.20, p=0.0001), greater self-efficacy (OR=2.60, 95% CI=1.29, 5.24, p=0.01) and higher income (OR=2.70, 95% CI=1.35, 5.37, p=0.005). Participants with greater levels of present temporal orientation were also more likely to report having a colonoscopy compared to those with lower levels (OR=1.18, 95% CI=0.99, 1.41, p=0.06) Conclusions: Colonoscopy is sub-optimal in a community-based sample of African Americans. In addition to psychological factors, participants who were more satisfied with their neighborhood conditions and those who had greater levels of present temporal orientation were likely to have a colonoscopy. Social and cultural factors may need to be addressed to enhance colonoscopy use among African Americans. Citation Format: Melanie S. Jefferson, Vanessa Briggs, Ernestine Delmoor, Jerry C. Johnson, Chanita Hughes-Halbert. Colonoscopy screening in a community sample of African Americans. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B79. doi:10.1158/1538-7755.DISP13-B79