Disparities in Colorectal Cancer Screening Practices in a Midwest Urban Safety-Net Healthcare System
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ORIGINAL ARTICLE
Disparities in Colorectal Cancer Screening Practices in a Midwest Urban Safety‑Net Healthcare System Abbinaya Elangovan1 · Jacob Skeans2 · Ishan Lalani1 · Farhan Ullah1 · Aparna Roy1 · David C. Kaelber1 · Gregory S. Cooper3 · Dalbir S. Sandhu1,4 Received: 22 January 2020 / Accepted: 6 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Aims Although colorectal cancer screening (CRC) using stool-based test is well-studied, evidence on fecal immunochemical test (FIT) patterns in a safety-net healthcare system utilizing opportunistic screening is limited. We studied the FIT completion rates and adenoma detection rate (ADR) of positive FIT-colonoscopy (FIT-C) in an urban safety-net system. Methods We performed a retrospective cross-sectional chart review on individuals ≥ 50 years who underwent CRC screening using FIT or screening colonoscopy, 09/01/2017–08/30/2018. Demographic differences in FIT completion were studied; ADR of FIT-C was compared to that of screening colonoscopy. Results Among 13,427 individuals with FIT ordered, 7248 (54%) completed the stool test and 230 (48%) followed up a positive FIT with colonoscopy. Increasing age (OR 1.01, CI 1.01–1.02), non-Hispanic Blacks (OR 0.87, CI 0.80–0.95, p = 0.002), current smokers (OR 0.84, CI 0.77–0.92, p
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