Mailed FIT Outreach Increases CRC Screening Rates: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On December 19, 2024, we reported on findings from a study published in JAMA Network Open that examined the effectiveness of a centralized colorectal cancer (CRC) screening outreach intervention involving mailed fecal immunochemical testing (FIT) outreach and patient navigation to colonoscopy after abnormal results of FIT.

The study

In the pragmatic randomized clinical trial, researchers investigated the effectiveness of the centralized, multilevel screening intervention among 4002 patients (mean age, 59.6 years; 56.4% women; 57.2% non-Hispanic White) at average risk for CRC and due for screening at two federally qualified health centers (FQHCs) in rural North Carolina.

Individuals in the intervention group received mailed screening outreach materials including an introductory letter, FIT kit packet with instructions and return postage, and 2 reminder letters, if necessary, in addition to usual care. Navigation to facilitate follow-up colonoscopy was offered to intervention participants with positive results of mailed FIT.

The primary outcome was completion of CRC screening within 6 months.

The findings

The centralized outreach intervention led to a 20.3 percentage-point increase in CRC screening completion among participants in the intervention group (30.0%) compared to the control group (9.7%). At the 12-month follow-up, the intervention group maintained higher screening rates, with 34.6% completing screening compared to 16.6% in the control group.

Authors' comments

"Centralized mailed FIT outreach intervention and patient navigation effectively increased CRC screening among diverse populations served by independent FQHCs. The intervention was effective across all insurance categories and was associated with increased detection of advanced colorectal neoplasia."

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