Sobia Mujtaba, MD, MPH1, Raj Dalsania, MD1, Deannys Batista, MD1, Angela Ward, DNP, FNP, BC2, Heba N. Iskandar, MD, MSc3, Jennifer Christie, MD1 1Emory University School of Medicine, Atlanta, GA; 2Emory University Hospital, Atlanta, GA; 3Emory University Division of Digestive Diseases, Atlanta, GA
Introduction: Colorectal cancer (CRC) screening and surveillance colonoscopy declined nationwide during the initial surge of coronavirus infectious disease (COVID-19), including at our ambulatory endoscopy center at Emory Healthcare in the state of GA, which in August 2020 was designated as the "most likely" state where someone may be exposed to COVID-19. To improve show rates, we implemented a quality improvement project centered on patient engagement through which we addressed concerns regarding COVID-19, and the safety of colonoscopy.
Methods: We contacted patients between the ages of 40-75 who were due for screening or polyp surveillance colonoscopy in August of 2020 via a telephone call through which we provided an overview of public health guidelines regarding COVID-19, safety precautions at our institution to minimize risk of transmission of COVID-19, including pre-procedural testing, social distancing guidelines, enforcing a universal masking policy, limited visitor policy, and vigorous surface disinfection. Post-procedure, patients completed a survey regarding the study phone call, and colonoscopy reports were reviewed.
Results: 161 patients were contacted, of which 49% were Caucasian, 48.4% were African-American and 1.9% were Asian. 152 patients (94.4%), including 75 Caucasians (49.3%), and 71 African-Americans (46.7%) completed their procedures. 91.8% agreed they received information about COVID-19 that they were unaware of; 91.1% felt safer about procedures after the phone call; 90.9% agreed that they felt less anxious about the risk of acquiring COVID-19; 70.3% agreed that they may not have come in for their procedures if they had not received the call.
206 adenomatous polyps, including 24 advanced adenomas (AN) (defined as ≥1 cm in size, adenoma with tubulovillous/villous histology or high grade dysplasia), and 1 locally invasive adenocarcinoma was found. Excluding the adenocarcinoma, there was no statistically significant difference between the proportions of African-American patients with adenomas when compared to the Caucasian patients (50.7% vs. 57.3%, Chi-square statistic= 0.64; p-value= 0.41).
Discussion: Our study suggests that specific communication of pandemic related issues are key to reducing peri-procedural concerns about COVID-19. Although our cohort was small, the findings of ANs, and a cancer further reinforces that failure of timely CRC screening and colonoscopy will lead to a large burden of missed polyps and CRC, leading to increased morbidity and mortality from CRC.
Sobia Mujtaba indicated no relevant financial relationships.
Raj Dalsania indicated no relevant financial relationships.
Deannys Batista indicated no relevant financial relationships.
Angela Ward indicated no relevant financial relationships.
Heba Iskandar indicated no relevant financial relationships.
Jennifer Christie indicated no relevant financial relationships.
Sobia Mujtaba, MD, MPH1, Raj Dalsania, MD1, Deannys Batista, MD1, Angela Ward, DNP, FNP, BC2, Heba N. Iskandar, MD, MSc3, Jennifer Christie, MD1. P1327 - Nipping It in the Bud – Patient Engagement and Prevention of Colorectal Cancer During the COVID-19 Pandemic: Results from a Quality Improvement Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.