P2337 - Colorectal Cancer Screening in Persons Living With HIV: Assessing Screening of Urban Underserved Populations

Salil Chowdhury, MD¹, Aaron Kahlam, MD², Wajiha Khan, BSc², Suraj Pai, MD³, Steven Keller, PhD², Sushil Ahlawat, MD², Diana Finkel, DO^4
1Thomas Jefferson University Hospital, Newark, NJ; ²Rutgers New Jersey Medical School, Newark, NJ; ³University of Michigan Health System, Ann Arbor, MI; ⁴NJMS, Newark, NJ

Introduction: Antiretroviral therapy has increased longevity and decreased mortality in persons living with human immunodeficiency virus (PLWH), leading to a shift in cancer rates in this population. Colorectal cancer (CRC) is the third leading cause of cancer-related death in North America and disproportionately affects African Americans, reflecting recent changes to screening guidelines. Our project will assess if we are screening our majority African American PLWH population for CRC at our Infectious Disease clinic in Newark, NJ.

Methods: A database of patients being managed for HIV, between the ages of 45 and 75 from the last four years was generated. Of the 1242 patient charts, 1199 were analyzed. Patient charts were excluded if they did not meet screening criteria. Retrospective chart review was conducted through Epic. Patient charts were assessed for adequate CRC screening based on the 2017 recommendations from the U.S. Multi-Society Task Force of Colorectal Cancer, which included screening African Americans between the ages of 45 and 50. Patient charts were analyzed by race, age, and viral load.

Results: The average age of our PLWH population was 58.7 years old and 79% was African American. Eighty percent of our patients relied on public insurance, charity care, or were uninsured. For our general patient population, 74% were referred for CRC screening and 43% underwent screening. For our African American patients, 73% were referred for CRC screening and 41% underwent screening. For our African American patients between the ages of 45 and 50, we found that 56% had been referred for screening and 31% underwent screening. When our results were separated by viral load, we found that patients with a viral load greater than 200 had a significantly lower screening rate compared to those with a viral load of less than 200. The results are shown in the table.

Discussion: In comparison to other underserved populations, our screening rates are comparable. The pandemic caused by the novel coronavirus (COVID-19) may have contributed to lower rates during this period. Provider education of new screening guidelines embedded in Epic, as well as increased targeting and support for patients with a higher burden of disease may help increase screening rates in this population.

	Total number of Patients	Number of patients referred for CRC	% of patients referred for CRC	95% Confidence interval	Number of patients screened for CRC	% of patients screened for CRC	95% Confidence Interval
Persons Living with HIV (PLWH)	1199	887	74%	71%-76%	510	43%	40%-45%
African American PLWH	945	668	73%	70%-76%	391	41%	38%-45%
African American PLWH between age 45 and 50	183	103	56%	49%-63%	56	31%	24%-38%
PLWH with Viral Load > 200	185	123	67%	59%-73%	62	34%	27%-41%
PLWH with Viral Load < 200	988	752	76%	73%-79%	441	45%	42%-48%

Table: CRC Screening and Referral Results by Race, Age, and Viral Load


Disclosures:
Salil Chowdhury indicated no relevant financial relationships.
Aaron Kahlam indicated no relevant financial relationships.
Wajiha Khan indicated no relevant financial relationships.
Suraj Pai indicated no relevant financial relationships.
Steven Keller indicated no relevant financial relationships.
Sushil Ahlawat indicated no relevant financial relationships.
Diana Finkel indicated no relevant financial relationships.


Salil Chowdhury, MD¹, Aaron Kahlam, MD², Wajiha Khan, BSc², Suraj Pai, MD³, Steven Keller, PhD², Sushil Ahlawat, MD², Diana Finkel, DO⁴. P2337 - Colorectal Cancer Screening in Persons Living With HIV: Assessing Screening of Urban Underserved Populations, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.