Determinants of compliance with colonoscopy in patients with adenomatous colon polyps in a veteran population

Aim: To determine factors affecting compliance of a follow-up colonoscopy in patients with previously diagnosed adenomatous colon polyps. Methods: A retrospective review was performed on patients with adenomatous polyps excised between January and December 1998. Twenty-nine clinical factors were assessed in patients grouped into whether they were compliant (n = 81) or noncompliant (n = 38) with follow-up colonoscopy. Significant variables by univariate analysis were included in multivariate regression. Results: One hundred and nineteen patients with adenomatous colon polyps were identified. Of 119 patients, 114 had a documented recommendation for follow-up of 5 years or less, with 69% having been compliant. In a univariate analysis, greater number of polyps (P = 0.04), NSAID use (P = 0.02), statin use (P = 0.005), first-degree relatives with colon cancer (P = 0.05) and compliance with out-patient clinic follow-up (P < 0.001) were significantly associated with patient compliance. Multivariate analysis revealed statin use (P = 0.05), first-degree relatives with colon cancer (P = 0.06) and compliance with out-patient clinic follow-up (P < 0.001) were independent predictors of compliance. Conclusions: History of statin use and family history of colon cancer are good predictors of compliance. The strongest predictor can be anticipated with compliance assessed with encounters for other visits. Strong efforts should be directed at improving patient education about colon cancer by the physician and facilitating patient compliance.