Gabriel Melki, MD
Post Graduate Medical Resident
St. Joseph's University Medical Center
Paterson, New Jersey
Gabriel Melki, MD, Moutaz Ghrewati, MD, Hadir Mohamed, MD, Ashima Kapoor, MD, Abdalla Mohamed, MD, Farhan Ayoub, MD, Alexander Wu, MD, Shaker Barham, MD, Linda Laham, BSc, Gres Karim, BSc, Maggie Hanna, MD, Chandra Chandran, MD, Walid Baddoura, MD
St. Joseph's University Medical Center, Paterson, NJ
Introduction: CRC is the third leading cause of cancer death, and therefore early detection by screening is beneficial. Residents in primary care clinics offer screening modalities for CRC starting at the age of 50. At a clinic in New Jersey, the primary method offered for screening has always been colonoscopy every 10 years starting at the age of 50. However, when patients refused colonoscopy, other less invasive tests were not being offered. A QI project was undertaken to assess the % of residents not offering less invasive tests, before and 6 months after education about CRC screening modalities.
Methods: 63 residents were surveyed about their preferred and alternate method of CRC screening. The questionnaire was anonymous. When colonoscopy was refused, results were obtained to assess the % of residents offering less invasive tests before and 6 months after being educated about CRC screening options.
Results: At this institution, results revealed that 73 % of residents offered colonoscopy as a first test, 19% FOBT and 8% other methods. 64 % of residents offered less invasive tests when colonoscopy was refused; this increased to 95% at 6 months post education, accounting for a 31% increase.
Discussion: Most cases of CRC develop from adenomatous polyps. Therefore, early detection and removal by colonoscopy reduces the risk of CRC development. Colonoscopy is the gold standard for CRC screening. However, other modalities are also approved such as yearly FOBT. It is important to offer these modalities when colonoscopy is declined. This QI project demonstrated that an educational intervention about CRC screening modalities given to residents in primary care clinics enhanced the number of patients being screened, especially in the group of patients who refused colonoscopy. In conclusion, offering more CRC screening methods yields to better medical care to our patients.
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Citation: Gabriel Melki, MD, Moutaz Ghrewati, MD, Hadir Mohamed, MD, Ashima Kapoor, MD, Abdalla Mohamed, MD, Farhan Ayoub, MD, Alexander Wu, MD, Shaker Barham, MD, Linda Laham, BSc, Gres Karim, BSc, Maggie Hanna, MD, Chandra Chandran, MD, Walid Baddoura, MD. P1144 - IMPROVING COLORECTAL CANCER (CRC) SCREENING BY OFFERING LESS INVASIVE TESTING WHEN PATIENTS REFUSE COLONOSCOPY: A QUALITY IMPROVEMENT (QI) PROJECT. Program No. P1144. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.