One-Third of Open Access Colon Cancer Screening Requests Require a Clinic Appointment

Background: Open access colonoscopy (OAC) allows for patients at low-risk for endoscopic complications to receive a colonoscopy (CSP) without a preprocedural appointment. This can reduce wait times for screening and increase appointment availability for symptomatic patients. Methods: At Walter Reed National Military Medical Center, we enacted an OAC program in 2014 for our TRICARE beneficiaries. Patients due for colon cancer screening or polyp surveillance can submit an online questionnaire through a secure website. Our scheduling department reviews all questionnaires, and patients with prespecified criteria are seen in clinic prior to their procedure. The remainder of patients have their surveys reviewed by a gastroenterologist for suitability and are scheduled for CSP or computed tomographic colonography. In 2018, the OAC program was expanded to all military hospitals in the national capital region (NCR). Results: Prior to expanding Walter Reed's OAC program, 6713 total screening requests were made. The requested procedure was CSP in 69.9% of patients. Of patients who fell outside the 45-75 age range, 14.1% were under the age of 45, and 2% were over the age of 75. 31.6% of OAC patients required a clinic appointment. Following incorporation of the NCR, 2290 screening questionnaires have been completed without significant change to the absolute percentages of those requiring appointments. Conclusion: By avoiding unnecessary clinic visits for asymptomatic individuals, OAC programs increase availability in gastroenterology practices to see symptomatic patients.