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Session: ePoster: Other Neoplasia and Endoscopy 8 (Sat315)

EP146 - Outcomes of a State-Sponsored Colonoscopy Program for Underserved Populations in Alabama

Saturday, May 10, 2025
3:53 PM – 3:58 PM PT
Location: Monitor 6, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Luis Rivera Aguasvivas, MD

    Colon and Rectal Fellow
    University of Alabama at Birmingham
    Birmingham, AL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • AH

    Alfonsus Adrian H. Harsono, MD, MSPH

    Postdoctoral Fellow
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

    Disclosure information not submitted.

  • Karin Hardiman, MD, Ph.D (she/her/hers)

    Professor
    University of Alabama at Birmingham
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

    Disclosure information not submitted.

  • Daniel I. Chu, MD, MSPH (he/him/his)

    Professor and Division Director
    University of Alabama at Birmingham
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • Robert Hollis, MD, MSPH

    Assistant Professor
    University of Alabama at Birmingham
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • GK

    Gregory D. Kennedy, MD, Ph.D, MBA (he/him/his)

    Professor Executive Vice Chair of the Department of Surgery
    University of Alabama at Birmingham
    University of Alabama at Birmingham
    Birmingham, AL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • PA

    Patricia Ajayi-Fox, MD

    Assistant professor
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Luis Rivera Aguasvivas, MD: This individual has no financial relationships with ineligible companies.
Daniel I. Chu, MD, MSPH: This individual has no financial relationships with ineligible companies.
Robert Hollis, MD, MSPH: This individual has no financial relationships with ineligible companies.
Gregory D. Kennedy, MD, Ph.D, MBA: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Significant inequities in colorectal cancer morbidity and mortality exists among underserved populations, and variation in screening rates contributes to these inequities. In response, the Alabama Department of Public Health (ADPH) implemented a state-sponsored colonoscopy screening program for low-income, under-insured residents of Jefferson County. Our aim was to examine characteristics of patients who participated in this program and report endoscopic screening findings.

Methods/Interventions: We performed a retrospective analysis of colonoscopy records from February 2023 to September 2024 among patients enrolled in the ADPH screening program. Patients were eligible for the ADPH program if they were a resident of Jefferson County, low income ( < 200% of federal poverty level), underinsured (self-reported), and were either due for a screening colonoscopy per national guidelines, had a positive fecal immunochemical test, or presented with concerning symptoms. Demographic data and endoscopic findings were collected, and summary measures were reported.

Results/Outcomes: A total of 202 patients completed a colonoscopy as part of the ADPH colorectal cancer screening program. The mean age of the participants was 56.9 years (SD = 5.9) and 54.5% of the patients were female. Racial composition included 75% Black, 5.9% White, 4.5% Asian, 6.9% Hispanic, 2% from other backgrounds, and 5.4% classified as unknown. Over half of patients were found to have colon polyps (66.3%, n=134); 48.6% (n=98) presented with 1-2 polyps and 17.7% (n=36) had 3-10 polyps. Polyps were adenomatous in histopathology among 48% (n=97) of patients. Overall, 1.9% (n=4) were identified with adenocarcinoma of the colon, of which n=3 were Stages I-III and n=1 was stage IV. Other diagnoses included inflammatory polyps, lipoma, submucosal leiomyoma, granulosa cell tumor, and neuroendocrine tumor, each identified in one patient.

Conclusion/Discussion: Participants in state-sponsored colonoscopy program were predominately from a minority background and had high rates of colon polyps and colorectal cancer. These findings highlight the critical role of public health initiatives in addressing inequities in colorectal cancer screening among underserved populations.