Jessica Sang, MD, MPH1, Andrew Simmelink, MD2, Travis Denmeade, MD1, Emily Ost, MD1
1Carolinas Medical Center, Charlotte, NC; 2Atrium Health / Carolinas Medical Center, Charlotte, NC
Introduction: Colon cancer is the third most common cause of cancer and cancer-related deaths. After regular colon screening was implemented, there was a 40% decline in incidence and mortality of colon cancer. The US Preventative Services Task Force gives grade A evidence recommendation for screening individuals age 50 through 75 that are of average risk. A US multi-society task force on colon cancer screening gave colonoscopy and Fecal Immunochemistry Test (FIT) a tier-1 recommendation. We sought to increase our internal medicine's clinic colon cancer screening rates.
Methods: We utilized the PDSA model for quality improvement. Baseline colon cancer screening rate was 53% in September 2018. The aim of our project was to increase colon cancer screening (CRCS) rates by 16.4% by April 2019 to a target goal of 69.4%, and to determine barriers to screening. A target goal of 69.4% was selected based on the clinic’s metric goal. Our two main interventions included an informational video about CRCS reasoning and methods combined with a questionnaire that addressed barriers to care and recreation of FIT card instructions which were deemed inadequate. Educational materials and questionnaire were available in English and Spanish. We tracked improvement through clinic CRCS rate data available to physicians.
Results: Colon cancer screening rates at Myers Park Internal Medicine Clinic were increased by 15% (goal: 16.4%) to 68%. Ninety-two percent found the informational video “extremely informative”, with 38% choosing colonoscopy, 46% FIT testing, and 8% Cologuard®.
Discussion: Our clinic showed simple interventions can increase CRCS rates. The increase in CRCS rates we have shown can potentially lead to more early diagnoses of colon cancer and lower health care costs for the health system. The workflow used in our study could also be used in other clinics throughout Atrium Health to assess for increased colon cancer screening rates in other populations. The format of a simple informational video rather than documents may be beneficial in educating patients on different health care topics. Next steps will include reasons for not completing either FIT testing or having colonoscopy performed.
Citation: Jessica Sang, MD, MPH; Andrew Simmelink, MD; Travis Denmeade, MD; Emily Ost, MD. P1140 - INCREASING COLON CANCER SCREENING RATES AT MYERS PARK INTERNAL MEDICINE CLINIC. Program No. P1140. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.