overview
Dr. Atuluru’s research is focused on barriers to follow-up care in
colorectal cancer patients who have undergone surgery. Colorectal cancer is a major cause of cancer deaths in the U.S. and worldwide and many patients undergo surgery for treatment. Surveillance colonoscopies are recommended to avoid recurrence, but only around half of patients get them at 1 year and the reasons for this were unknown before this project started. Dr. Atuluru worked directly with patients and providers to identify factors that prevent completion of surveillance colonoscopies., with the goal of improving post-operative surveillance over time.
Dr. Atuluru’s interest in colorectal cancer is driven by its disproportionate impact on people from lower socioeconomic backgrounds and minority communities, as well as the potential for early detection that completely changes the course of a patient’s life. She hopes that her research, we can define and and start to address the socioeconomic barriers that contribute to disparities in colon cancer care.
Research methods & Results
In Dr. Atuluru’s study examining patient-level factors, she and her co-researchers found that both cognitive and environmental elements significantly influenced surveillance colonoscopy completion. The most reported barriers were fears surrounding colonoscopy results and cancer recurrence, as well as challenges with bowel preparation. On the other hand, the strongest facilitators included patients’ motivation to seek reassurance and the support they received from the clinic in scheduling their appointments.
“These findings are extremely important because they help us design interventions that are directly guided by what patients report. When we combine these insights with our earlier work on provider-identified factors, we gain a more complete picture of what affects surveillance colonoscopy completion in colorectal cancer survivors.”
When combined with earlier work on provider-identified factors, these data provide a more complete picture of surveillance colonoscopy completion in colorectal cancer survivors. Based on this, clinics could consider offering nurse navigation visits to address patient concerns early and help schedule follow up colonoscopies. These data also suggest that exploring low-volume bowel prep options may help reduce prep-related barriers. Building on this work, our next study will examine whether nurse navigation or interactive web-based education can improve adherence to surveillance colonoscopy.
After residency, Dr. Atuluru plans to complete a chief resident year at the VA, followed by application to a GI fellowship.
“Thanks to Rachel Issaka and Yutaka Tomizawa, mentors who have played a major role in shaping my interest in GI, and Neha Naidoo, who supported me from my very first year as a resident and made the challenges of residency and research so much easier to navigate!”