Cancer
Evaluation of Colorectal Cancer Screening of Minority Populations at Community Safety Net Clinics: A Retrospective Chart Review Willie Rajvong* Willie Rajvong Rajvong Rajvong Rajvong Rajvong Rajvong Rajvong Rajvong Baylor College of Medicine
Introduction: The fecal immunochemical test is used to screen for colorectal cancer. However, patients must navigate multiple steps from test ordering to colonoscopy after a positive result. Disruptions during this process may delay cancer diagnosis and exacerbate existing disparities in high-risk, predominantly minority populations. This study aimed to evaluate FIT testing and colonoscopy uptake in a predominantly minority population.
Methods: This study is a retrospective chart review focused on 837 patients aged 50-75 who visited a primary care physician at community safety net clinics in Houston, Texas, for an annual wellness visit between January 1, 2021, and December 31, 2022, and had a follow-up visit within the subsequent 12 months. Relevant patient characteristics, FIT results, referrals, and colonoscopy results were extracted from medical records to evaluate referrals and follow-up related to FIT testing.
Results: Among patients, the majority were female (61.41%), Hispanic (71.41%), and had a mean age of 56.4 years. Among these patients, 97.61% had FIT tests ordered, and 97.80% of those were returned. In total, there were 129 (16.15%) FIT tests that were positive. Among positive FIT tests, 94.57% were referred for colonoscopies, 42.97% had colonoscopies performed, and 88.52% of colonoscopies performed had abnormal findings. Of these abnormal findings, 55.56% reported polyps, 35.19% reported hemorrhoids, and 22.22% reported other abnormalities, including diverticulosis.
Conclusion: Nearly all eligible patients had FIT tests ordered, and nearly all were returned. However, while the majority of positive FIT tests were referred for colonoscopies, less than half had colonoscopies performed. Further investigations are needed into potential barriers to having colonoscopies performed in this predominantly minority population.