P1292 - Multidisciplinary Direct Access Colonoscopy Program at a Tertiary Care Center Identifies Patients With High-Risk Lesions

Lisa F. Barrett, DO¹, Christina DiMaria, DO, RD², Simone A. Jarrett, MD¹, Brenda Chiang, DO¹, Matthew Hoch, DO¹, Dahnish Valiani, DO¹, Michael Goldberg, DO^1
1Einstein Healthcare Network, Philadelphia, PA; ²Allegheny General Hospital, Pittsburgh, PA

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer related death in men and women combined in the United States. Colonoscopy remains the gold standard for CRC screening, and over 30% of eligible patients are not being screened for colon cancer. Several barriers have been identified by both patients and physicians limiting completion of this life saving screening procedure. Direct access colonoscopy (DAC) is a program designed to increase compliance of CRC screening as it allows healthy, age-appropriate patients to defer an in-office consultation with a Gastroenterologist and schedule a screening colonoscopy directly. Although there are multiple DAC programs in the United States, there is limited data supporting its value. Our DAC program included representatives from Gastroenterology, Primary Care, Information Technology/Systems, quality improvement, and marketing. We present a retrospective study of a DAC program in a combined urban and suburban area over an 11-month time period demonstrating increased CRC screening colonoscopies.

Methods: This single-centered, retrospective study was conducted at Albert Einstein Medical Center in Philadelphia and was approved by the institutional review board. We recorded and analyzed DAC completed between January 1, 2019 and November 30, 2019.

Results: The number of colonoscopies performed from January to November 2019 increased by 18.6% compared to 2018. 11.5% of this increase can be attributed to the DAC program. 1,127 patients were referred to the program, passed the criteria to participate, and were scheduled for colonoscopy during this time. Ultimately, 840 (74.5%) of these patients completed CRC screening with colonoscopy. The patient demographics and results of the completed colonoscopies can be found in the attached table.

Discussion: Implementation of a Direct Access Colonoscopy program increased CRC screening rates at our institution. Our novel multidisciplinary approach to the DAC program was successful in increasing the overall number of colonoscopies performed, improving our colon cancer screening rate across the network, and identified almost 11% of these patients to have high risk lesions or malignancy. Further research should be conducted to assess if implementation of a multidisciplinary DAC program at other centers could lead to improved CRC screening rates and identification of high-risk lesions, ultimately saving patient lives and decreasing healthcare costs due to early intervention.



Disclosures:


Lisa F. Barrett, DO¹, Christina DiMaria, DO, RD², Simone A. Jarrett, MD¹, Brenda Chiang, DO¹, Matthew Hoch, DO¹, Dahnish Valiani, DO¹, Michael Goldberg, DO¹. P1292 - Multidisciplinary Direct Access Colonoscopy Program at a Tertiary Care Center Identifies Patients With High-Risk Lesions, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.