Delays in receiving follow-up colonoscopy after an abnormal fecal immunochemical test (FIT) result are associated with increased colorectal cancer incidence and mortality. Little is known about patterns of follow-up colonoscopy completion in federally qualified health centers. We abstracted the medical records of health center patients, aged 50–75 years, who had an abnormal FIT result between August 5, 2017 and August 4, 2018 (N = 711). We assessed one-year rates of colonoscopy referral, pre-procedure visit completion, colonoscopy completion, and time to colonoscopy; associations between these outcomes and patient characteristics; and reasons for non-completion found in the medical record. Of the 711 patients with an abnormal FIT result, 90% were referred to colonoscopy, but only 52% completed a pre-procedure visit, and 43% completed a colonoscopy within 1 year. Median time to colonoscopy was 83 days (interquartile range: 52–131 days). Pre-procedure visit and colonoscopy completion rates were relatively low in patients aged 65–75 (vs. 50–64), who were uninsured (vs. insured) or had no clinic visit in the prior year (vs. ≥ 1 clinic visit). Common reasons listed for non-completion were that the patient declined, or the provider could not reach the patient. Efforts to improve follow-up colonoscopy rates in health centers might focus on supporting the care transition from primary to specialty gastroenterology care and emphasize care for older uninsured patients and those having no recent clinic visits. Our findings can inform efforts to improve follow-up colonoscopy uptake, reduce time to colonoscopy receipt, and save lives from colorectal cancer. Trial registration: National Clinical Trial (NCT) Identifier: NCT03925883.

中文翻译：

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大便异常筛查结果后的结肠镜随访：结肠镜检查完成过程的步骤分析

在粪便免疫化学测试 (FIT) 结果异常后延迟接受后续结肠镜检查与结直肠癌发病率和死亡率增加有关。关于在联邦合格的卫生中心完成后续结肠镜检查的模式知之甚少。我们提取了 2017 年 8 月 5 日至 2018 年 8 月 4 日期间 FIT 结果异常的健康中心患者（50-75 岁）的病历（N = 711）。我们评估了一年内结肠镜检查转诊率、术前就诊完成率、结肠镜检查完成率和结肠镜检查时间；这些结果与患者特征之间的关联；以及病历中未完成的原因。在 FIT 结果异常的 711 名患者中，90% 被转诊到结肠镜检查，但只有 52% 完成了术前就诊，43% 的人在 1 年内完成了结肠镜检查。结肠镜检查的中位时间为 83 天（四分位距：52-131 天）。在 65-75 岁（与 50-64 岁）、未投保（与投保）或上一年未就诊（与 ≥ 1 次临床就诊）的患者中，术前就诊和结肠镜检查完成率相对较低. 列出的未完成的常见原因是患者拒绝，或提供者无法联系到患者。提高卫生中心结肠镜检查随访率的努力可能侧重于支持从初级到专业胃肠病学护理的护理过渡，并强调对老年未投保患者和最近没有就诊的患者的护理。我们的研究结果可以为改善后续结肠镜检查的使用、减少接受结肠镜检查的时间以及挽救结肠直肠癌的生命提供信息。