Rolling-out Screening Volume Affecting Compliance Rate and Waiting Time of FIT-based Colonoscopy

Hsiao Hsuan Jen, Chen Yang Hsu, Sam Li Sheng Chen, Amy Ming Fang Yen, Sherry Yueh Hsia Chiu, Jean Ching Yuan Fann, Yi Chia Lee, Ming Shiang Wu, Wen Feng Hsu, Szu Min Peng, Hsiu Hsi Chen, Han Mo Chiu

Research output: Contribution to journalArticle

Abstract

Background and Study Aims: The population-based colorectal cancer screening program with fecal immunochemical test (FIT) from the inaugural period to the rolling-out period may create a higher demand for colonoscopies, but such a change has not been quantified. We intended to assess the change in the compliance rate and the waiting time (WT) for a colonoscopy and the associated geographic and institutional variations across the 2 periods. Materials and Methods: Data from the Taiwanese nationwide colorectal cancer screening program were analyzed. The data included a total of 46,235 FIT-positive cases of 1,258,560 tests in the inaugural period (2004 to 2009) and 270,700 FIT-positive cases of 3,723,789 tests in the rolling-out period (2010 to 2013). The compliance rate and WT for colonoscopy after positive FIT was ascertained and compared between the 2 periods. Results: The rolling-out period resulted in a decline of 16.0% for compliance rate and yielded an additional 1,778,499 waiting days with variation across geography and institution. After adjusting for relevant factors, a decrease in compliance rate by 8.5% and an increase of 714,648 waiting days were still noted. In the rolling-out period, a remarkable decline in compliance rate by 9.8% was found in middle Taiwan, and the longest WT (1,260,109 d) was observed in southern Taiwan. Screening at public health centers led to a 19% decrease in compliance rate and an increase of 2,546,746 waiting days. Conclusions: The decrease in compliance rate and an increase in the WT with variation across geography and institution resulting from the increased volume of rolling-out FIT screening provide an insight into optimal resource allocation of clinical capacity for colonoscopy.

Original languageEnglish
Pages (from-to)821-827
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume52
Issue number9
DOIs
Publication statusPublished - Oct 1 2018

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Colonoscopy
Geography
Taiwan
Early Detection of Cancer
Colorectal Neoplasms
Resource Allocation
Public Health
Population

Keywords

  • colonoscopy
  • colorectal cancer screening
  • waiting time

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Rolling-out Screening Volume Affecting Compliance Rate and Waiting Time of FIT-based Colonoscopy. / Jen, Hsiao Hsuan; Hsu, Chen Yang; Chen, Sam Li Sheng; Yen, Amy Ming Fang; Chiu, Sherry Yueh Hsia; Fann, Jean Ching Yuan; Lee, Yi Chia; Wu, Ming Shiang; Hsu, Wen Feng; Peng, Szu Min; Chen, Hsiu Hsi; Chiu, Han Mo.

In: Journal of Clinical Gastroenterology, Vol. 52, No. 9, 01.10.2018, p. 821-827.

Research output: Contribution to journalArticle

Jen, HH, Hsu, CY, Chen, SLS, Yen, AMF, Chiu, SYH, Fann, JCY, Lee, YC, Wu, MS, Hsu, WF, Peng, SM, Chen, HH & Chiu, HM 2018, 'Rolling-out Screening Volume Affecting Compliance Rate and Waiting Time of FIT-based Colonoscopy', Journal of Clinical Gastroenterology, vol. 52, no. 9, pp. 821-827. https://doi.org/10.1097/MCG.0000000000000955
Jen, Hsiao Hsuan ; Hsu, Chen Yang ; Chen, Sam Li Sheng ; Yen, Amy Ming Fang ; Chiu, Sherry Yueh Hsia ; Fann, Jean Ching Yuan ; Lee, Yi Chia ; Wu, Ming Shiang ; Hsu, Wen Feng ; Peng, Szu Min ; Chen, Hsiu Hsi ; Chiu, Han Mo. / Rolling-out Screening Volume Affecting Compliance Rate and Waiting Time of FIT-based Colonoscopy. In: Journal of Clinical Gastroenterology. 2018 ; Vol. 52, No. 9. pp. 821-827.
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AU - Jen, Hsiao Hsuan

AU - Hsu, Chen Yang

AU - Chen, Sam Li Sheng

AU - Yen, Amy Ming Fang

AU - Chiu, Sherry Yueh Hsia

AU - Fann, Jean Ching Yuan

AU - Lee, Yi Chia

AU - Wu, Ming Shiang

AU - Hsu, Wen Feng

AU - Peng, Szu Min

AU - Chen, Hsiu Hsi

AU - Chiu, Han Mo

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N2 - Background and Study Aims: The population-based colorectal cancer screening program with fecal immunochemical test (FIT) from the inaugural period to the rolling-out period may create a higher demand for colonoscopies, but such a change has not been quantified. We intended to assess the change in the compliance rate and the waiting time (WT) for a colonoscopy and the associated geographic and institutional variations across the 2 periods. Materials and Methods: Data from the Taiwanese nationwide colorectal cancer screening program were analyzed. The data included a total of 46,235 FIT-positive cases of 1,258,560 tests in the inaugural period (2004 to 2009) and 270,700 FIT-positive cases of 3,723,789 tests in the rolling-out period (2010 to 2013). The compliance rate and WT for colonoscopy after positive FIT was ascertained and compared between the 2 periods. Results: The rolling-out period resulted in a decline of 16.0% for compliance rate and yielded an additional 1,778,499 waiting days with variation across geography and institution. After adjusting for relevant factors, a decrease in compliance rate by 8.5% and an increase of 714,648 waiting days were still noted. In the rolling-out period, a remarkable decline in compliance rate by 9.8% was found in middle Taiwan, and the longest WT (1,260,109 d) was observed in southern Taiwan. Screening at public health centers led to a 19% decrease in compliance rate and an increase of 2,546,746 waiting days. Conclusions: The decrease in compliance rate and an increase in the WT with variation across geography and institution resulting from the increased volume of rolling-out FIT screening provide an insight into optimal resource allocation of clinical capacity for colonoscopy.

AB - Background and Study Aims: The population-based colorectal cancer screening program with fecal immunochemical test (FIT) from the inaugural period to the rolling-out period may create a higher demand for colonoscopies, but such a change has not been quantified. We intended to assess the change in the compliance rate and the waiting time (WT) for a colonoscopy and the associated geographic and institutional variations across the 2 periods. Materials and Methods: Data from the Taiwanese nationwide colorectal cancer screening program were analyzed. The data included a total of 46,235 FIT-positive cases of 1,258,560 tests in the inaugural period (2004 to 2009) and 270,700 FIT-positive cases of 3,723,789 tests in the rolling-out period (2010 to 2013). The compliance rate and WT for colonoscopy after positive FIT was ascertained and compared between the 2 periods. Results: The rolling-out period resulted in a decline of 16.0% for compliance rate and yielded an additional 1,778,499 waiting days with variation across geography and institution. After adjusting for relevant factors, a decrease in compliance rate by 8.5% and an increase of 714,648 waiting days were still noted. In the rolling-out period, a remarkable decline in compliance rate by 9.8% was found in middle Taiwan, and the longest WT (1,260,109 d) was observed in southern Taiwan. Screening at public health centers led to a 19% decrease in compliance rate and an increase of 2,546,746 waiting days. Conclusions: The decrease in compliance rate and an increase in the WT with variation across geography and institution resulting from the increased volume of rolling-out FIT screening provide an insight into optimal resource allocation of clinical capacity for colonoscopy.

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