title: Patient Non-adherence and Cancellations Are Higher for Screening Colonoscopy Compared with Surveillance Colonoscopy.
abstract: BACKGROUND
  A significant proportion of the eligible population is non-adherent to colonoscopy for colorectal cancer (CRC) screening.
  
  
  OBJECTIVE
  To define the demographic and clinical variables associated with non-adherence and multiple cancellations to scheduled colonoscopy within 1 year in a CRC screening and adenomatous polyp surveillance population.
  
  
  METHODS
  This was an observational cohort study of 617 consecutive patients scheduled to undergo colonoscopy at an outpatient academic tertiary care center for CRC screening or adenomatous polyp surveillance from January 2012 to September 2012.
  
  
  RESULTS
  Overall, 551 patients (89.3%) were adherent and 66 (10.7%) were non-adherent to scheduled colonoscopy at 1 year. The relative risk for non-adherence was 5.42 [95% confidence interval (CI) 2.74-10.75] in patients undergoing colonoscopy for screening compared to those for surveillance (16.7 vs. 3.5% non-adherence, respectively, P < 0.001). An indication of screening in comparison with surveillance was associated with non-adherence [odds ratio (OR) 12.69, 95% CI 4.18-38.51] and multiple cancellations (OR 2.33, 95% CI 1.27-4.31) by multiple regression analysis.
  
  
  CONCLUSIONS
  Patients undergoing colonoscopy for CRC screening are significantly less likely to attend their scheduled procedure within a year and have more procedure cancellations than those undergoing surveillance colonoscopy.
authors.affiliation: Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, 1725 West Harrison, Suite 206, Chicago, IL, 60612, USA. Michael_Greenspan@rush.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Greenspan
authors.affiliation: Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, 1725 West Harrison, Suite 206, Chicago, IL, 60612, USA. Navdeep_S_Chehl@rush.edu.
authors.forename: Navdeep
authors.initials: N
authors.lastname: Chehl
authors.affiliation: Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, 1725 West Harrison, Suite 206, Chicago, IL, 60612, USA. Krista_Shawron@rush.edu.
authors.forename: Krista
authors.initials: K
authors.lastname: Shawron
authors.affiliation: Department of Neurological Sciences and Behavioral Sciences, Rush University Medical Center, 600 S. Paulina Street, Suite 1022g, Chicago, IL, 60612, USA. Lisa_L_Barnes@rush.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Barnes
authors.affiliation: Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Triangle Office Building, Suite 470, Chicago, IL, 60612, USA. Hong_Li2@rush.edu.
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Triangle Office Building, Suite 470, Chicago, IL, 60612, USA. Elizabeth_Avery@rush.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Avery
authors.affiliation: Rush University Medical Center, 1700 W. Van Buren, Triangle Office Building, Suite 371, Chicago, IL, 60612, USA. Shannon_Sims@rush.edu.
authors.forename: Shannon
authors.initials: S
authors.lastname: Sims
authors.affiliation: Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, 1725 West Harrison, Suite 206, Chicago, IL, 60612, USA. John_Losurdo@rush.edu.
authors.forename: John
authors.initials: J
authors.lastname: Losurdo
authors.affiliation: Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, 1725 West Harrison, Suite 206, Chicago, IL, 60612, USA. Sohrab_Mobarhan@rush.edu.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Mobarhan
authors.affiliation: Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, 1725 West Harrison, Suite 206, Chicago, IL, 60612, USA. Joshua_Melson@rush.edu.
authors.forename: Joshua
authors.initials: J
authors.lastname: Melson
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003113:Colonoscopy / Q000379:methods / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012737:Sex Factors; D014481:United States
keywords: Adherence; Colonoscopy; Colorectal cancer screening; Surveillance