P0265 - Epidemiologic Differences in Colorectal Polyp Histology and ADR in Patients Undergoing Colonoscopy After FIT in the Texas Panhandle

Eugene C. Nwankwo, MD, MS¹, Jefferson Lines, BS², Sahiba Trehan, ³, Michelle Balducci, ², Amit Trehan, MBBS⁴, kuldip Banwait, MD⁵, Srinivas Pathapati, MD⁴, Subhasis Misra, MD, MS⁶, Izi Obokhare, MD^2
1St. Louis University School of Medicine, St. Louis, MO; ²Texas Tech University Health Sciences Center, Amarillo, TX; ³Texas Tech University Health Sciences Center, College Station, TX; ⁴BSA Health System, Amarillo, TX; ⁵Panhandle Gastroenterology, Amarillo, TX; ⁶Brandon Regional Hospital, Brandon, FL

Introduction: There is limited knowledge about the relationship between Adenoma Detection (ADRs), patient ethnicity, and histologic differences of adenomatous polyps in patients who undergo colonoscopy with a positive fecal immunochemical test (FIT). We hypothesized that colonoscopy done on these patients would yield higher ADRs, and better risk stratify patients based on the types of cancerous polyps.

Methods: We reviewed ADRs for colonoscopies performed after a positive FIT test and compared them to ADR rates for routine colonoscopy performed without an initial FIT test between November 2014 and March 2017 at multiple endoscopy sites. Data were compare to a national outpatient sample.

Results: 979 patients underwent FIT. 12.1% (n=119) tested positive. 32.8% (n=39) had one or more tubular adenomatous (TA) polyps on pathological examination. Among these, the majority were female, 64.1% (n=25). 15.9% (n=19) had a hyperplastic polyp, 1.7% (n=2) had findings consistent with ulcerative colitis and 0.8% (n=1) had adenocarcinoma. The control group (n= 2603) underwent colonoscopy as the initial screening tool, 719 had at least one TA. Control group ADR rate was 27.5% and cancer rate was 1%.

Of the total individuals screened with FIT and colonoscopy, there was a mean ADR of 38.7% among Blacks. Within this cohort, the ADR varied slightly between adenoma types. Rates were 46% for Hyperplastic Adenomas (HA), 39% for Tubulous Adenoma (TA), and 31% for Tubulovillous Adenomas (TVA). Among Hispanics, the ADR for HA was 20%, 80% for TA, and 7% for TVA. Asian/Pacific Islanders showed ADR of 10% (HA), 30% (TA), and 10% for TV (P< 0.001).

Discussion: Overall, ADR’s were highest for the most aggressive types of polyps were found to be highest in non-white patients compared to their white counterparts. ADR increased when colonoscopy was conducted after a positive FIT test. Colonoscopies after a positive FIT test will improve ADRs significantly, and also lower the overall healthcare cost for screening colon cancer in this era of escalating healthcare costs.


Disclosures:
Eugene Nwankwo indicated no relevant financial relationships.
Jefferson Lines indicated no relevant financial relationships.
Sahiba Trehan indicated no relevant financial relationships.
Michelle Balducci indicated no relevant financial relationships.
Amit Trehan indicated no relevant financial relationships.
kuldip Banwait indicated no relevant financial relationships.
Srinivas Pathapati indicated no relevant financial relationships.
Subhasis Misra indicated no relevant financial relationships.
Izi Obokhare indicated no relevant financial relationships.


Eugene C. Nwankwo, MD, MS¹, Jefferson Lines, BS², Sahiba Trehan, ³, Michelle Balducci, ², Amit Trehan, MBBS⁴, kuldip Banwait, MD⁵, Srinivas Pathapati, MD⁴, Subhasis Misra, MD, MS⁶, Izi Obokhare, MD². P0265 - Epidemiologic Differences in Colorectal Polyp Histology and ADR in Patients Undergoing Colonoscopy After FIT in the Texas Panhandle, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.