North Central Bronx Hospital Bronx, NY, United States
Michail Kladas, MD1, Maria Gabriela Rubianes Guerrero, MD2, Osayande Osagiede, MD, MPH2, Donald P. Kotler, MD2 1North Central Bronx Hospital, Bronx, NY; 2Jacobi Medical Center, Bronx, NY
Introduction: Effective screening programs have reduced CRC incidence by up to 70% in specific populations. However, participation rates are low especially among disadvantaged populations. We compared demographics, disease characteristics, and clinical stages of CRC patients referred for screening (S) or diagnostic (D) procedures.
Methods: We constructed a de-identified database of CRC patients seen between January 1, 2016, and June 1, 2021. Patients who were symptomatic and underwent a diagnostic procedure (D), and patients who were referred for screening colonoscopy (S) were compared. Demographic and clinical data were extracted from the electronic health record. Variables of interest included age, sex, race, BMI, cigarette smoking, diabetes, continuity (seen > once in a primary care setting (Family Medicine, Internal Medicine, ObGyn) within 5 years of being diagnosed with CRC) vs non-continuity patients, right vs left colon (separated at splenic flexure), and non-advanced (Stages 0-2) vs advanced (Stages 3-4). Fisher exact test was used to compare stage, sex, presence of symptoms, and lesion location between the two groups. Two tailed t test was used to compare BMI and age.
Results: 292 patients were included, 69.2% were (D) while 27.3% were (S). Of the 292 patients, 54.4% was found to have advanced CRC and 42.4% non-advanced. Mean age was 62, there were 55% women and 45% men, and around 75% percent were African American or Hispanic. Mean BMI was 27.8, 35% were diabetic, and 54.4% had a history of cigarette smoking. Around 80% of patients had signs or symptoms at diagnosis.
There was a significant difference in disease stage between D and S; 83% of D had advanced CRC at diagnosis versus 17 % in S, (p< 0.001). A greater proportion of D patients had a history of smoking (p< 0.005). Differences in sex, age, BMI, and location between D and S were not statistically significant.
Discussion: In this retrospective study of CRC screening in two public hospitals, advanced CRC was more common in symptomatic patients. We also found that more than 2/3 of our continuity patients with CRC presented with symptoms compared to >90% of non-continuity CRC patients (data reported separately). Separate approaches are needed to increase the uptake of screening of CRC and to increase the amount of people that establish a primary care follow-up, in this disadvantaged population.
Disclosures: Michail Kladas indicated no relevant financial relationships. Maria Gabriela Rubianes Guerrero indicated no relevant financial relationships. Osayande Osagiede indicated no relevant financial relationships. Donald Kotler indicated no relevant financial relationships.
Michail Kladas, MD1, Maria Gabriela Rubianes Guerrero, MD2, Osayande Osagiede, MD, MPH2, Donald P. Kotler, MD2. P1298 - Association Between Colorectal Cancer (CRC) and Disease Stage in Patients Undergoing Screening versus Diagnostic Procedures in a Public Hospital in New York City, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.