Factors Influencing Non-Attendance in Endoscopy: A Prospective Study

Aims This study aimed to identify and characterize the factors that influence DNA and short-notice cancellations (within 3 days) in a large tertiary, JAG-accredited endoscopy unit in Ireland. The focus was on understanding patient demographics and reasons for non-attendance, to inform strategies that might reduce DNA rates.

Methods This prospective analysis involved patients referred for upper gastrointestinal endoscopies (OGDs), colonoscopies, and sigmoidoscopies between June and September 2024. Data were collected on patient demographics, procedure type, urgency of referral, and reasons for cancellation or non-attendance. Statistical analysis was performed using parametric tests and binary logistic regression.

Results A total of 428 patients who DNA’d or cancelled within 3 days were compared to 343 patients who attended their appointments. Male patients were significantly more likely to DNA or cancel at short notice 60.1% vs 39.9% (p<0.001). Age (p=0.606), procedure type (p=0.824), and socioeconomic status (p=0.231) were not found to be significantly associated with non-attendance. Subgroup analysis revealed that 39.5% of cancellations were due to patients being unavailable or away, 12.4% no longer wanted or needed the procedure, and 6.6% had the procedure performed elsewhere. Other reasons included illness (34.5%), bereavement (3.1%), and failure to prepare for the procedure (2.3%).

Conclusions This study demonstrated that men are more likely to DNA or cancel at short notice compared to women, but other demographic factors such as age, procedure type, and socioeconomic status did not significantly influence non-attendance rates. These findings suggest that interventions to reduce DNA rates should be universal and not targeted to specific demographic groups. Being unavailable was the most common reason for DNA/cancellation. Strategies such as appointment confirmation systems, and better coordination between multiple referral pathways may help reduce non-attendance and enhance the efficiency of endoscopy services. Additionally, addressing logistical barriers, such as procedure availability or patient unpreparedness, could further mitigate the impact of short-notice cancellations.

Publication History

Article published online:
27 March 2025