An Online Risk Assessment Tool Demonstrates Patient Risk Factors and Behaviors Associated with Uptake of Colorectal Cancer Screening

low, medium, or high risk of CRC based on reported personal and family history of CRC/ polyps and personalized screening/surveillance recommendations according to the US MultiSociety Task Force on CRC guidelines. A univariate analysis was performed to assess factors associated with reported uptake of colorectal screening; a p-value of less than 0.05 was considered statistically significant. Multiple imputation analysis to include data points with incomplete responses was performed. Results: 27,233 responses were analyzed (Table 1). The mean age of the cohort was 48.1 years. 66% were female and 34% were male. 76.1% reported white ethnicity. Of the 27,233 respondents, 36.5% reported adherence to CRC screening. 3,385 respondents noted a previous diagnosis of polyps and 313 reported a previous diagnosis of CRC. Demographic and lifestyle factors significantly associated with CRC screening adherence included female gender, higher BMI, white ethnicity, diet with greater than 3 daily servings of fruits, grains, and vegetables, exercise greater than 30 minutes per day at least four times per week and less smoking exposure (all, p < 0.001) (Table 2). Respondents with a family history of CRC and polyps in a first-degree relative were also significantly more likely to be adherent with screening; 35.7% were adherent compared to 19.4% of participants without an affected first-degree relative (p <0.001). Participants who were scored as low, medium, or high risk based on family history compared to those who scored average risk were 2.1, 5.3 and 5.3 times more likely to have a positive screening history respectively (p<0.001). Conclusion: This large, online CRC risk survey demonstrates demographics and lifestyle factors associated with adherence to CRC screening. These results highlight important data describing individuals who have decreased participation in CRC screening. Patient education should target these at-risk groups to improve utilization.

Table 1

Table 1

Table 2

Table 2

Su1746 AN ONLINE RISK ASSESSMENT TOOL DEMONSTRATES PATIENT RISK FACTORS AND BEHAVIORS ASSOCIATED WITH UPTAKE OF COLORECTAL CANCER SCREENING David W. Dornblaser, Rocio Lopez, Lisa LaGuardia, Margaret O'Malley, Brandie Heald, James M. Church, Matthew Kalady, Carol A. Burke

Su1747 FOLLOW-UP OF PATIENTS UNNDERGOING COLONOSCOPY ASSESSEMENT FOLLOWING A POSITIVE SCREENING TEST. COMPLIANCE WITH SURVEILLANCE RECOMMENDATIONS AND CRC RISK Carlo Senore, Arrigo Arrigoni, Paola Cassoni, Mario Fracchia, Lorenzo Orione, Paola Armaroli, Stefano Rosso, Cesare Hassan, Nereo Segnan

Introduction: The historical decline in colorectal cancer (CRC) mortality is partially attributed to screening. However, CRC screening is still underutilized in the United States (US) population. We created an online CRC risk assessment tool and used the patient-generated information to assess demographics, lifestyle behaviors, and family history of CRC and polyps that are associated with CRC screening adherence. Methods: Self-reported data was collected via an Institutional Review Board approved online risk assessment tool (Ccf.org/score). Data collected included a participant's age, gender, ethnicity, height, weight, dietary factors, smoking history, physical activity level, personal and family history of CRC or polyps, and adherence to CRC screening (colonoscopy in last 10 years, flexible sigmoidoscopy in last 5 years, or fecal occult blood testing in last year). A participant was given a score of average,

Aim. To assess CRC incidence and compliance with surveillance recommendations among subjects detected with adenomas in a screening setting. Methods. Follow-up of subjects undergoing colonoscopy assessment (TC), following a positive FIT, or FS, between 1/1/2004 and 31/12/2011, within the Piedmont (Italy) population based CRC screening programme. Screenees referred for surveillance are actively invited to undergo the planned surveillance TC. All subjects were classified in 3 risk groups according to the EU guidelines: low-risk

S-545

AGA Abstracts

AGA Abstracts

27,233 participants were performed. Results: 27,233 responses were analyzed (Table 1). The mean age of the cohort was 48.1 years. 66% were female and 34% were male. 76.1% reported white ethnicity and average BMI was 28.0. Former and current smokers composed 38.2% of participants. Of the 27,233 respondents, 36.5% reported adherence with CRC screening (colonoscopy in last 10 years, stool blood testing in last year, or sigmoidoscopy in last 5 years). 3,385 respondents reported a previous diagnosis of colorectal polyps and 313 reported a previous diagnosis of CRC. In the complete case analysis, older age, nonwhite ethnicity, greater BMI, smoking exposure, and a first-degree relative with polyps or CRC were significantly associated with a personal history of polyps or CRC (Table 2). Respondents who reported eating more than 3 servings of fruits, grains, and vegetables per day and exercising greater than 30 minutes a day four days per week were both less likely to be associated with personal history of CRC or polyps. Non-white individuals were more likely to report a personal history of CRC while white individuals were more likely to report a history of polyps. Conclusion: Our online risk assessment tool highlights the non-modifiable and modifiable risk factors associated with CRC and polyps. These results emphasize modifiable factors that can alter the risk of CRC. Clinicians should use these data to recommend dietary and lifestyle modifications to decrease CRC risk and promote adherence to CRC screening/surveillance.