A mobile app to improve adherence to colorectal cancer screening and post polypectomy surveillance guidelines

Abstract

Background: Despite significant advances in prevention and early detection, colorectal cancer (CRC) is a leading cause of cancer mortality worldwide. Inadequate adherence and/or lack of knowledge of guidelines have shown to prevent adequate screening and surveillance recommendations and hinder effective screening programs.

Objective: Evaluate the implementation and real-world impact of a mobile app designed to optimize CRC screening and surveillance in accordance to recently updated guidelines.

Methods: A mobile app including ergonomic algorithms integrating all pertinent guideline information was created by a group of experts. Data were collected from Catalonia healthcare professionals using the app between February 2023 and May 2024. Users' characteristics, consultation types, and patient data were analyzed to assess app's implementation, usage patterns, and impact on CRC screening and surveillance outcomes.

Results: A total of 12,481 consultations were recorded; 3,054 (24.4%) screening and 9,427 (75.6%) post-polypectomy surveillance consultations. The app was increasingly and repeatedly used by professionals during the study period (72% retention rate). Among screening consultations, 2,082 (68.2%) patients were classified as average risk, suggesting the use of fecal occult blood test (FOBT) instead of colonoscopy. Among surveillance consultations, the app advised deferring follow-up colonoscopies and using FOBT instead in 4,748 (50%) patients based on negative index colonoscopy or the presence of low-risk polyps. Standard surveillance with colonoscopy at 3 years was recommended for 3,224 (34.1%) patients and intensive surveillance, requiring a colonoscopy at 1 year, was indicated for 749 (7.9%) patients.

Conclusions: A CRC screening and surveillance mobile app showed remarkable acceptance and uptake among healthcare professionals. Proper implementation of updated guidelines aided by the use of the app could significantly reduce the number of unnecessary screening and post-polypectomy surveillance colonoscopies, as well as help identifying high risk patients who require intensive surveillance.

Clinical trial: Not applicable.

Keywords: Colon cancer; Colorectal cancer; Mobile app; Prevention programs; Screening.

Fig. 1

a, b,c App screenshots showing the main menu, the screening function data loader, and the screening query results. d, e, f the main menu, the surveillance functions data loader, and the surveillance function query results

Fig. 2

Use of the app by healthcare professionals over the analyzed period. (Screening and surveillance post-polypectomy consultations)

Fig. 3

Quality of colonoscopies

Fig. 4

Potential colonoscopy savings among Captyva screening (A) and surveillance consultations (B)