P0251 - Patient-Reported Barriers to FIT Test Completion at a Single Institution

Erica Graff, MD¹, Neelima Gaddipati, MD, MBA², Ramon O. Minjares, MD², Angeli Patel, MD³, Candido Pezon, BS³, Paul Feldman, MD^3
1University of Miami Miller School of Medicine, Miami, FL; ²University of Miami, Jackson Memorial Hospital, Miami, FL; ³Bruce W. Carter Miami VA, Miami, FL

Introduction: Colorectal cancer (CRC) is the fourth most common cancer and the second-leading cause of cancer-related death in the United States. The United States Preventive Services Task Force recommends CRC screening in all adults between ages 45 and 75, as it has shown a substantial reduction in long-term CRC risk and mortality. Annual Fecal Immunohistochemistry Testing (FIT) has emerged as an acceptable first-line test for CRC screening as it is low risk and cost effective.

Methods: We performed a single-center, retrospective, quality improvement (QI) study to determine barriers to FIT test completion between March 2020 and December 2020 at the Miami Veterans Affairs Medical Center (VAMC). The methodology for patient selection is outlined in Figure 1 and an intention to treat analysis was used. The electronic medical record was searched for all patients who had an outstanding FIT order. Participants were randomly selected to answer a phone survey using a random number generator. The survey was adapted from the validated survey used by Bhise et al. (2016) in order to assess patient-specific and health system barriers.

Results: The baseline characteristics and reasons for failure to return FITs are shown in Table 1. Of the 120 total survey respondents, 52.5% of patient stated that they did not receive the test. Additionally, 37.5% of patients stated that they forgot about the test and of those patients, 73.5% stated that a reminder from their provider would have been helpful. Other reasons for failing to return the test included a lack of education from the provider about the benefits of CRC screening (35.8%) and not being interested in CRC screening (5%). Only 15.8% of patients would have preferred an alternative method of CRC screening and over 80% of respondents stated that they would retake an FIT test if it was made available to them.

Discussion: Colorectal cancer is a leading cause of morbidity and mortality in the United States; therefore, screening is imperative. FIT has emerged as a non-invasive first-line alternative to colonoscopy, as it is 94% specific. Despite the low risk and convenience associated with FIT testing, our study shows that many obstacles still exist for patients to complete their tests. Future resources and emphasis should be placed on patient and provider education to ensure that patients understand their options for and the benefits of CRC screening.




Disclosures:


Erica Graff, MD¹, Neelima Gaddipati, MD, MBA², Ramon O. Minjares, MD², Angeli Patel, MD³, Candido Pezon, BS³, Paul Feldman, MD³. P0251 - Patient-Reported Barriers to FIT Test Completion at a Single Institution, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.