eP298 - Unmasking Disparities: Overcoming Hurdles in Colonoscopy Completion Among Hispanic/Latino Populations

ePoster Presenter(s)

• 

  Alberto J. Parra Vitela, MD. MS (he/him/his)

  Colorectal Fellow
  Cook County Health System
  Madison, WI, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• SG

  Sheldon Gong, Bachelor of Science

  Medical Student
  Chicago Medical School at Rosalind Franklin University of Medicine and Science
  San Francisco, California, United States

  Disclosure information not submitted.
• BO

  Brendan D. O’Donnell, MD

  Fellow
  Cook County Health
  Chicago, Illinois, United States

  Disclosure information not submitted.
• 

  Jimmie Knight, III, MD

  Resident
  Rush University Medical Center
  Rush University Medical Center
  Chicago, IL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• 

  Alejandra Perez-Tamayo, MD

  Assistant Professor of Surgery, Colon and Rectal Surgery Division
  Cook County Health and Hospitals System, University of Illinois at Chicago
  Chicago, Illinois, United States

  Disclosure information not submitted.
• JH

  Jacqueline Harrison, FACS, FASCRS

  Division Chair, Colon and Rectal Surgery
  John H. Stroger, Jr. Hospital
  Hinsdale, Illinois, United States

  Disclosure information not submitted.

Senior Author(s)

• NM

  Nathalie Mantilla, MD MPH

  Colorectal Surgeon
  Cook County Health & Hospitals System
  Chicago, Illinois, United States

  Disclosure information not submitted.

Purpose/Background: Colorectal cancer (CRC) is the second most common cause of cancer deaths in the USA. In the past few decades, the incidence of CRC has increased in younger populations. Colonoscopy is the gold standard for diagnosis and therapy for removal of polyps. Hispanic/Latinos are one of the most vulnerable groups at risk of being diagnosed with advanced colorectal cancer, worse prognosis, and higher costs. Our aim is to identify factors that lead to lower rates of screening colonoscopies in this population.Methods/Interventions: A retrospective review of scheduled colonoscopies by primary physicians was conducted from 2018 to 2023 at Cook County Hospital Chicago. Demographic data and documented reasons for refusal or cancellation of the colonoscopies were collected and analyzed using SPSS v.29 by IBMResults/Outcomes: A total of 42,202 colonoscopies were scheduled between 2018 to 2023. The median age of the population was 61 (53 – 67) and sex distribution was 52% and 48%, male and female respectively. The incidence rate of cancellations/no-show appointments was 36% in the total study. In our study, 35% identified as Hispanic/Latino. Of those that identified as Hispanic/Latino, the median age was 56 (49 – 65) and sex distribution was 48% and 52%, male and female respectively. When focusing on this population alone, they had a 29.8% incidence rate of cancellations/no-show appointments. Women were more adherent to recommendations by primary providers. Reasons for cancelation/no-shows were lack of transportation, lack of insurance, no time-off work, no escort, fear of contracting COVID-19 infection, and lack of explanation by health practitioners. However, accurate proportions of these reasons were hard to calculate due to inconsistent reporting of reasons in the electronic medical record.Conclusion/

Discussion: There is abundant data in disparity in care, however the specific limiting factors have not been fully elucidated, Hispanic/Latinos are an at-risk population of developing advanced colorectal cancer due to lack of screening. Use of the socio-ecological model can be used to assess the complex interplay between factors that contribute to poor health outcomes in at-risk populations. Improved identification and documentation of barriers to completion screening colonoscopies, especially in vulnerable populations, may increase colorectal screening rates."figure 1 Hispanic vs non hispanic

Figure 2; Total population
"