Direct Access Colonoscopy Screening May Aid in Closing Screening Gaps

A pilot program for Direct Access Colonoscopy Screening (DACS) increased overall screening rates for colorectal cancer by nearly 100% in a selected cohort, according to study results.
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The researchers also reported high patient satisfaction, suggesting that DACS programs can serve as effective alternatives for traditional colonoscopy screening.

Colorectal cancer is the second leading cause of cancer death in the United States. The disease is preventable through early detection; however, close to 60% of patients aged 50 years or older report never undergoing a colonoscopy. Barriers including lack of access to gastroenterologists, procedure-related anxiety, and lack of knowledge may impede patients from receiving timely colonoscopies.

Researchers from Advocate Illinois Masonic Medical Center (Chicago, IL) developed the DACS program to close gaps in colonoscopy screening. Introduced in July 2015, the program enrolled patients without significant comorbidities who were screened telephonically by a nurse navigator. Nurse navigators provided an overview of all procedures and required preparation prior to colonoscopy. Patients who were deemed ineligible for the DACS were referred to a gastroenterologist for traditional colonoscopy procedures.

A retrospective review of the program’s first year (July 2015 through July 2016) found that of 644 patients referred to DACS, 58% (n = 373) met inclusion criteria for the program. Of this cohort, 289 completed their colonoscopy by the time of reporting. Normal colonoscopies accounted for 70% (n = 201) of procedures performed; the remaining 30% (n = 88) were found to have at least one adenoma.

The researchers did not observe any complications in patients enrolled in DACS. Patients enrolled in the program also reported higher satisfaction scores than patients who received their colonoscopies through traditional means. DACS enrolment caused colonoscopy receipt to nearly double, from 30% prior to implementation to 59% following implementation.

“[DACS] is a safe and effective alternative to the conventional process of obtaining a colonoscopy and can positively impact patient satisfaction and outcomes,” the researchers said.