HSR22-157: We Answered the Call to Continue Colorectal Cancer Screening of Disparate Patients Despite COVID-19

Colorectal cancer (CRC) screening of uninsured and medically underserved South Carolinians has been the goal of Colorectal Cancer Prevention Network (CCPN) for 12 years. Due to COVID19, screening was halted for 3 months. Two fecal immunochemical tests (FITs) were issued at the height of the shutdown (April-May 2020) with a 100% (2/2) FIT return rate. This was a 96% reduction (57 issued in April-May 2019); 56/57 (97%) FITs were returned. No colonoscopies were performed (vs 81 in April-May 2019). Fewer patients were screened for CRC in FY20 (680 vs 737 in 2019), evidence that our nationally recognized face-to-face FIT patient navigation model needed modifications to address pandemic-associated barriers. CCPN’s revisions facilitated FIT completion without an in-person clinic visit. Integral to this modification was virtual patient navigation (VPN) via HIPAA-compliant video/phone conferencing. It also included mailed FIT, visual education materials, and how-to videos. Using VPN, we reached over twice as many patients in 2021 (731 vs 223 FITs issued face-to-face in 2019); more FITs were also completed (563 in 2021 vs 204 in 2019). Fewer colos were done in 2021 (333 vs 533 in 2019), but more CRC screenings were performed overall (896 patients screened in 2021 vs 737 in 2019). Of 333 colos done in 2021, 35 were as FIT+ follow-ups (35/78, a 45% FIT+ to colo completion rate). In FY19, 34 FIT+ patients were identified; 20/34 completed colos (59% FIT+ completion rate). The pandemic limited colo slots, but FIT+ patients were prioritized to ensure CRC screening completion. With 13 colos still pending for FY21, the FIT+ screening completion rate could be as high as 62% (48/78). Regarding potential impact on disparities, African American (AA) participation was highest at 47% of those screened in 2021 (vs 33% Caucasian). Spanish support services allowed screening of Hispanics, the 3rd most prevalent population screened in 2021 (145/896, 16%). These demographics are consistent with pre-COVID observations-45% AA (336/746), 18% Hispanic (135/746), 33% Caucasian (246/746) in 2019. Our data suggests that VPN was effective in screening minorities and the underserved for CRC. Despite the pandemic, our CRC screening numbers exceeded the number of patients screened pre-COVID, including FIT+ to colo completions. The CCPN will proceed with VPN in its efforts to address healthcare disparities by increasing CRC screening in vulnerable populations across our state.