S563 Unequal Access, Uneven Preps: How Insurance and Economic Status Impact Colonoscopy Preparation—Insights from a National Database

Introduction: Race significantly influences the quality of colon preparation for colonoscopies, which are vital for early colorectal cancer detection and prevention. Disparities exist among racial groups, shaped by cultural norms, healthcare access, and personal health behaviors. This study examines these factors to better understand the root causes of such inequalities. These insights can help healthcare providers and policymakers improve equity in colorectal cancer prevention and ensure fair access to effective screening. Methods: This retrospective study analyzed colonoscopy records from 2010 to 2023. Data included information on colonoscopy reports, gender, race, colon preparation quality, socioeconomic status, and insurance coverage. Chi-squared tests were used to evaluate the relationships between poor colon preparation and categorical variables, including race, socioeconomic status, and insurance status. Logistic regression analysis was performed to assess the combined impact of these variables on colon preparation outcomes. Statistical significance was determined with a P-value threshold of 0.05. Results: The study included data from 3,330 individuals who underwent colonoscopies between 2010 and 2023, with 64% of participants being female. Racial demographics were as follows: 24.2% Hispanic, 48% White, 15% Black, 6% Asian, and 3% Other. Analysis revealed a significant association between race and poor colon preparation (Chi-square = 40.78, P < 0.01), with Hispanics experiencing the highest rate of poor outcomes (P = 0.023). Additionally, lower socioeconomic status showed a strong correlation with inadequate preparation (Chi-square ≈ 20.86, P ≈ 0.00011), and the lack of insurance was also significantly associated with poor outcomes (Chi-square ≈ 15.48, P ≈ 0.000083). Conclusion: This study highlights significant disparities in colon preparation quality among racial groups, with outcomes heavily influenced by socioeconomic status and insurance coverage. The findings emphasize that race, financial constraints, and lack of insurance are critical determinants of colonoscopy preparation quality. Despite its limitations, this study underscores the importance of addressing these disparities. Healthcare providers and policymakers must incorporate these demographic considerations into strategies to ensure equitable access to colorectal cancer screenings and improve prevention efforts for underserved populations.