Adherence To Colonoscopy After Positive Fecal Immunochemical Testing Is Related To Patient Navigation and Distance From Center

Douglas K. Rex, MD, MASGE Idos GE, et al. Clin Transl Gastroenterol 2021 Feb.

In a comparison of colonoscopy adherence after positive fecal immunochemical testing (FIT) in 2017 without patient navigation (PN) versus 2018 with navigation, overall completion of colonoscopy increased from 40.6% to 46% with PN. Exposure to PN increased the adherence to colonoscopy by 4-fold. There was a 1% drop in colonoscopy adherence for each 1-kilometer (km) increase in distance from a patient’s residence to the center located in Los Angeles. These data suggest that adherence would change from 60% with a residence located very near the center to 25% with a distance of 100 km.


The overall colonoscopy completion rates after positive FIT in this study, as in a number of others, is substantially below the quality target of 80% recommended by the Multi-Society Task Force on Colorectal Cancer. Patient navigation appears important. Expanding the geographic availability of colonoscopy might increase colonoscopy adherence given the striking distance observations in this study.

Douglas K. Rex, MD, MASGE

Bio and Disclosures


Idos GE, Bonner JD, Haghighat S, et al. Bridging the gap: patient navigation increases colonoscopy follow-up after abnormal FIT. Clin Transl Gastroenterol 2021;12:e00307. (