INTRODUCTION Surveillance colonoscopy 1 year after surgical resection for patients with stages I-III colorectal cancer (CRC) is suboptimal, and data on factors associated with lack of adherence are limited. Using surveillance colonoscopy data from Washington state, we aimed to determine the patient, clinic, and geographical factors associated with adherence. METHODS Using administrative insurance claims linked to Washington cancer registry data, we conducted a retrospective cohort study of adult patients diagnosed with stage I-III CRC between 2011 and 2018 with continuous insurance for at least 18 months after diagnosis. We determined the adherence rate to 1-year surveillance colonoscopy and conducted logistic regression analysis to identify factors associated with completion. RESULTS Of 4,481 patients with stage I-III CRC identified, 55.8% completed a 1-year surveillance colonoscopy. The median time to colonoscopy completion was 370 days. On multivariate analysis, older age, higher-stage CRC, Medicare insurance or multiple insurance carriers, higher Charlson Comorbidity Index score, and living without a partner were significantly associated with decreased adherence to 1-year surveillance colonoscopy. Among 29 eligible clinics, 51% (n = 15) reported lower-than-expected surveillance colonoscopy rates based on patient mix. DISCUSSION Surveillance colonoscopy 1 year after surgical resection is suboptimal in Washington state. Patient and clinic factors, but not geographic factors (Area Deprivation Index), were significantly associated with surveillance colonoscopy completion. These data will inform the development of patient-level and clinic-level interventions to address an important quality-of-care issue across Washington.

中文翻译：

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患者层面、诊所层面和地理层面因素与一年结肠镜检查依从性监测之间的关联。

简介 I-III 期结直肠癌 (CRC) 患者手术切除后 1 年的结肠镜检查监测效果欠佳，并且与缺乏依从性相关的因素的数据有限。使用来自华盛顿州的结肠镜检查监测数据，我们旨在确定与依从性相关的患者、诊所和地理因素。方法 利用与华盛顿癌症登记数据相关的行政保险索赔，我们对 2011 年至 2018 年间诊断为 I-III 期 CRC 的成年患者进行了一项回顾性队列研究，这些患者在诊断后至少持续投保 18 个月。我们确定了 1 年监测结肠镜检查的依从率，并进行逻辑回归分析以确定与完成相关的因素。结果 在 4,481 名 I-III 期 CRC 患者中，55.8% 完成了为期 1 年的结肠镜监测监测。完成结肠镜检查的中位时间为 370 天。多变量分析显示，年龄较大、CRC 分期较高、医疗保险或多家保险公司、查尔森合并症指数评分较高以及没有伴侣生活与 1 年监测结肠镜检查依从性下降显着相关。在 29 家符合条件的诊所中，51% (n = 15) 报告的基于患者组合的监测结肠镜检查率低于预期。讨论 在华盛顿州，手术切除后 1 年进行的监测结肠镜检查效果不佳。患者和临床因素，但与地理因素（区域剥夺指数）无关，与监测结肠镜检查的完成情况显着相关。这些数据将为患者级别和诊所级别干预措施的制定提供信息，以解决整个华盛顿州的重要护理质量问题。