Title: CRC Screening Completion Rates at BPC

Author(s): Frank Castro, MD

First Author Email: fcastro1@mercy.com

Institution: SEBH

Residency: Family Medicine (SEBH)

Introduction: Colorectal cancer (CRC) remains a major contributor to global cancer-related morbidity and mortality. Screening is a cornerstone of preventative healthcare, and current USPSTF recommends routine screening for average-risk adults aged 45–75 years. Several validated screening modalities are used including colonoscopy, fecal immunochemical testing (FIT), and stool DNA testing combined with FIT (sDNA-FIT aka Cologuard). Although the clinical performance of these tests is well established, population-level benefit depends on multiple patient factors. Prior reports have demonstrated substantial variability in completion rates across screening strategies, emphasizing the value of practice-specific data.

Methods: A retrospective chart review was conducted for Boardman Primary Care (BPC) patients aged 45–75 years who had screening colonoscopy referrals, Cologuard orders, or FIT orders placed within an 18-month period (July 2024 – January 2026). Diagnostic testing and evaluations for symptomatic patients were excluded. Due to electronic reporting limitations, data were extracted manually. The 18-month timeframe was selected to increase the number of eligible screening orders while accounting for recommended testing intervals. IRB approval was not required, as the project did not meet criteria for human subjects research.

Results: Completion rates varied by modality. Among 67 patients ordered Cologuard, 44 completed testing (65.7%), while 23 (34.3%) did not. Of 62 patients referred for colonoscopy, 52 completed (83.9%), and 10 (16.1%) did not. FIT testing was infrequently ordered; of seven patients four completing (57.1%) and three didn’t (42.9%). Colonoscopy completion was significantly higher than Cologuard completion (p = 0.018). Comparison between the observed Cologuard completion rate and previously reported manufacturer data did not demonstrate statistical difference (p = 0.44).

Discussion/Conclusion: This review demonstrated high completion rates for colonoscopy and moderate completion rates for Cologuard. Study limitations include small sample size, low FIT utilization, manual data extraction, and reliance on a single reviewer, restricting generalizability. Conclusion: Within BPC, colonoscopy showed higher completion than stool-based testing, though adherence was acceptable across modalities. These findings support continued use of multiple CRC screening options while recognizing that completion rates may differ by patient population.