Patient Navigation Increased Colonoscopy Follow-up on Abnormal FIT

SAN ANTONIO - Fecal immunochemical tests (FIT) are an effective colorectal cancer screening method. However, timely follow-up of abnormal results is critical to the method’s effectiveness.

A new study by Gregory Idos, MD, assistant professor of clincal medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, and colleagues examined the use of a patient navigator program (PNP) to encourage follow-up colonoscopy among patients with abnormal FIT. They presented results of the study at the on Sunday, October 27, 2019, at the 2019 Annual Scientific Meeting of the American College of Gastroenterology, in San Antonio, Tex.

Introduction of the PNP at 5 tertiary hospitals within the Los Angeles County Department of Health Services system resulted in an overall increase in patients undergoing follow-up colonoscopy after abnormal FIT results, and this follow-up occurred within a shorter time interval than prior to the PNP program.

Between June 2018 and December 2018, 1,217 patients aged 50 to 75 years had abnormal FIT results (43% were men). These patients were assisted by the PNP to complete their follow-up colonoscopy within 6 months.

Prior to program initiation, the mean time from abnormal FIT to colonoscopy was 167 days. After PNP initiation, the interim improved to 117 days. Additionally, the frequency of colonoscopy completion increased in those patients who had patient navigation compared with patients who did not receive navigation (53% vs 40.5%).

Among those patients who had navigation, 50.2% who underwent colonoscopy had adenomatous polyps,
24% had high-risk adenomas, and 2% had colorectal cancer.

“In this interim analysis, we demonstrate that the integration of a patient navigator program for colorectal cancer screening may be instrumental in increasing adherence to recommended screening guidelines across a large safety net health system,” Idos and colleagues wrote.

Source: Idos G, Herman D, Haghighat S, et al. An interim analysis of a patient navigation program (PNP) to improve colonoscopy access after abnormal FIT. Poster P0125 presented at: ACG 2019 Annual Scientific Meeting; October 27, 2019; San Antonio, Tex. as: American College of Gastroenterology.