Greg S Thompson, MD, Lee West, MD, Mark A Parker, MD. Brookwood Baptist Health
Colorectal cancer is the 4th most common cancer and 2 most common COD. In Alabama, it is among the top 6 in regards to mortality. There are several methods of screening for CRC but the most widely used are stool tests and colonoscopy. Stool tests include the FIT and FOBT which require samples with low sensitivity and will miss polyps. These are recommended as annual screening in conjunction with flexible sigmoidoscopy. Ultimately statistics have shown a 67% reduction in risk of death for CRC compared to no endoscopy.
The FITWAY program is a statewide program of the ADPH aimed at providing colorectal screening to AL residents. Patients receive a FIT test at their local clinic at age 50 and would be referred to have a colonoscopy if positive or recommended under current screening guidelines. Our study looked at the results a specific practice which is made up of 3 experienced colorectal surgeons who have participated in the program since May 2016. Data from 265 patients spanning 15 months was reviewed concentrating on age, gender, comorbidities, FIT results, prep adequacy and each of those associated ADR.
265 patients were examined and of the 19% who had a positive FIT, 45% had an adenoma found on endoscopy. Of the 26 pts w/ negative FIT, 30% had an adenoma detected on endoscopy. The average age of patients screened was 56 and this was the first colonoscopy for 85% of them. 2/3 of patients screened were women. Overall patient prep was acceptable with 93% having adequate prep and only 3% having to be aborted. The ADR was equivalent to the national rate for endoscopists at 37% and well above the accepted rate of >25%. Of the comorbidities assessed for patients w/ adenomas detected, 71% had HTN and 56% had history of smoking. 35% of those with hypertension had an adenoma found and 55% of smokers had an adenoma detected. 1 cancer was detected throughout all these.
We estimate 6 colorectal cancers prevented and 325 thousand dollars saved in the small study thus far. FITWAY has provided a cost effective screening and prevention service to the underserved population of Alabama. With adequate funding, a strong referral base of PCP’s, and sufficient amount of gastroenterologists and colorectal surgeons we could begin to chip away at the national statistics and bring down Alabama’s incidence rate of colorectal cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93795
Program Number: P307
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster
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