P3179 - Evaluating Factors Affecting Colon and Endometrial Cancer Screening Rates in Patients Diagnosed With Lynch Syndrome at a Single Institution

Bao Sean Nguyen, MD¹, Lindsay Valenti, MD², Sartajdeep Kahlon, MD³, Machelle Wilson, PhD⁴, Joseph Marsano, MD^2
1UC Davis Medical Center, Sacramento, CA; ²University of California Davis Medical Center, Sacramento, CA; ³University of California Davis Medical, Sacramento, CA; ⁴University of California Davis, Sacramento, CA

Introduction: Patients with Lynch syndrome (LS) have a 40-60% lifetime risk for colon (CRC) and endometrial (EC) cancer. Screening for CRC in LS patients with colonoscopy reduces CRC-related morality, yet colonoscopy adherence ranges from 50-80% in international studies. Evidence supporting endometrial cancer screening in LS is weaker but still recommended. This study will evaluate factors that predict adherence for colonoscopy and endometrial screening at a tertiary care academic medical center.

Methods: The UC Davis Health System database was queried for patients with any diagnosis codes that contained terms related to LS during the study period of 1/1/2015 to 12/31/2022. This interval was chosen to coincide with the updated ACG and ACOG LS guidelines in 2015. Patients >18 years of age with a confirmed diagnosis of LS by germline testing were included. Patients were excluded if they did not have follow-up with a primary care provider, gastroenterologist, or gynecologist at our institution within the study period. Manual chart review was performed to evaluate clinical data, colonoscopy and endometrial screening intervals. Guideline recommended screening intervals with a 6-month grace period were used to determine appropriate vs inappropriate screening colonoscopy adherence. We used chi-square tests to examine associations between clinical and demographic factors with adherence.

Results: A total of 319 patients were initially identified. After manual chart review, 101 patients met inclusion criteria. When using the upper bound colon cancer screening interval, 61.7 % (58/94) of patients were appropriately screened. For female patients with intact uterus and therefore eligible for endometrial screening, a similar screening rate adherence of 66% (28/42) was observed. Of the clinical and demographic data collected, incorrect healthcare maintenance (HCM) documentation of colonoscopy interval was significantly associated with inappropriate colonoscopy adherence (Table 1).

Discussion: Overall, the colonoscopy and endometrial screening rates at this tertiary care academic center were comparable to prior studies. We found that incorrect HCM documentation was associated with inappropriate colonoscopy adherence. This reinforces the fact that accurate HCM documentation is important, particularly for LS patients who require more frequent screening intervals. Future directions will focus on tools to enhance the current healthcare maintenance module based on LS diagnosis codes.


Disclosures:


Bao Sean Nguyen, MD¹, Lindsay Valenti, MD², Sartajdeep Kahlon, MD³, Machelle Wilson, PhD⁴, Joseph Marsano, MD². P3179 - Evaluating Factors Affecting Colon and Endometrial Cancer Screening Rates in Patients Diagnosed With Lynch Syndrome at a Single Institution, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.