Feature May 18, 2022 John Bernot, MD

Colonoscopy challenges: Managing the social determinants of health for colorectal cancer screenings

Here are five ways Ayva can help your patients overcome SDOH factors preventing them from getting or scheduling a colonoscopy.

Colonoscopy challenges: Managing the social determinants of health for colorectal cancer screenings

According to the American Cancer Society, colorectal cancer is the third leading cause of cancer-related deaths in the United States.1

The good news is that with a five-year survival rate of 90%, it’s highly treatable when detected early.2

However, nearly 20% of people between 50-75 years of age—those most at risk— have never been screened.3 

While health insurance and the ability to pay for a colonoscopy are contributing factors, social determinants of health (SDOH) also prevent some patient populations from obtaining this critical preventative health screening.

Following, I will examine four SDOH factors that may be preventing your patients from getting a colonoscopy and how a digital health tool that increases patient engagement can help identify and overcome the challenges. 

4 reasons people don’t get colonoscopies

Here are four social determinants of health that may prevent individuals from getting, scheduling, or adequately preparing for a colonoscopy. 

  1. Transportation. Most surgery centers require patients to confirm they have an adult who can drive them home after a colonoscopy in order to schedule the procedure. Ride-sharing and taxis are typically only approved if another adult accompanies them when they leave the appointment, thus making an adult companion still a requirement. This transportation requirement impacts two types of patient populations: those without access to a vehicle and those who may be socially isolated. 
  2. Cultural barriers. Cultural barriers can lead to unique healthcare experiences. Understanding various cultural barriers across communities is critical to delivering the right care at the right time.4  
  3. Expectations. Attitudes and beliefs—including fear, embarrassment, and assumptions about the test prep—are among the top reasons people do not get colonoscopies.5 Setting realistic expectations can help patients make a more informed decision. 
  4. Health literacy. Colonoscopy prep is complex, even for people with high levels of health literacy. Same-day cancellations and failure to complete a colonoscopy are most commonly associated with inadequate bowel prep and poor adherence to the instructions and timeline.6

5 ways to manage SDOH with technology

Implementing an easy-to-use digital health tool can help your health system or ASC manage and overcome the SDOH factors impacting your patient populations.

Here’s how: 

  1. Connect individuals with caregivers and community resources that can help arrange transportation.
  2. Provide customized educational content that addresses specific concerns prevalent in target populations. 
  3. Offer peace of mind with 24/7/365 access to resources about what to expect before, during, and after a colonoscopy, including answering questions about the prep. 
  4. Share how-to videos and instructions with images appropriate for all language and literacy levels.
  5. Send text alerts to remind patients when to complete tasks to help with adequate and timely colonoscopy prep.

The right digital health tool can also help your care team overcome common patient-provider communication roadblocks.

Make Ayva part of your preventative health screening strategy

Colonoscopies save lives and reduce costs associated with colorectal cancer treatment. 

Addressing the social determinants that may be preventing everyone in your patient population from being screened as appropriate is critical to any preventative health strategy. 

Ayva is a dynamic patient engagement platform that can increase activation for every care journey, including colonoscopies. 

Meet Ayva today!


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Bravado Health


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  1. Key Statistics for Colorectal Cancer. American Cancer Society.
  2. Colorectal Cancer Early Detection, Diagnosis, and Staging. American Cancer Society.
  3. Use of Colorectal Cancer Screening Tests. Centers for Disease Control (CDC) and Prevention.
  4. Minority Health & Colorectal Cancer. Colon Cancer Coalition.
  5. Understanding Barriers to Colorectal Cancer Screening in Kentucky. Centers for Disease Control (CDC) and Prevention.
  6. Bowel preparation before colonoscopy. Gastrointestinal Endoscopy VOLUME 81, ISSUE 4, P781-794, APRIL 01, 2015.