Su1051 Dietary Macronutrients Alter Erk2-AKT1-PGE2 Pathway in Barrett's Mucosa: Potential Role During Carcinogenesis in Barrett's Epithelium

Background: No-shows and appointment cancellations are especially salient to gastroenterology. Data shows that the incidence of colorectal cancer is down-trending, which correlates to increased colorectal cancer awareness and increase in the number of per capita screening colonoscopies. Patients lost to follow-up because of a no-show or cancellation (NS/C) might be at a higher risk of developing malignancy because of a missed screening opportunity. If particular patient demographics can be identified that are associated with NS/C, specific interventions can be proposed to capture those patients at possible increased risk. Aim: To determine if certain patient demographics contribute to the NS/C. Methods: A retrosepctive chart review using the Computerized Patient Records System (CPRS) at the Carl T.Hayden VA Medical Center in Phoenix, Arizona analyzed 17 weeks of data regarding NS/C. Data was obtained regarding the patient's: age, gender, new vs. follow appointment, type of procedure vs. clinic appointment, reason for appointment, and origin of the appointment, whether within the GI department or through open access primary care consultation. Results: 17 weeks of data were reviewed. A majority were male (92.2%). Ages ranged from 23-88 years and average age was 57.5 years old. 14.8% of patients were younger than 50. More NS/C were for follow-ups (55.8%) rather than new consults (44.2%). There were also more NS/C for colonoscopies (73.8%) than EGD's (24.1%) and paracentesis contributed to only 1.9% of the total. Appointments originating from outside the GI department were more likely to result in NS/C as 73.6% of those appointments originated from the PCP. Only 26.1% of NS/C originated from within the GI department. A specific analysis of coloscopy was made (table) revealing that 265 colonoscopies were performed. 19.3% of the NS/C colonoscopies scheduled for symptomatic complaints (pain, diarrhea, constipation, hematochezia) came from within the GI department while 80.7% came from the patient's PCP. This was supported by an overwhelming majority of /C screening and surveillance appointments that also came from outside the GI department (87.1%). Conclusions: This data illustrates that of patients who fail to keep their appointments, they are likely to be older than 50, with asymptomatic complaints, who are referred to the GI department by their PCP's. This is valuable information because patients lost in the NS/C process represent a missed opportunity for possible positive interventions including but not limited to the prevention of colorectal cancer. By identifying these variables, steps can be taken to minimize their contribution to the NS/C rate in the future.