MAILED fecal immunochemical testing (FIT) kits using centralized outreach significantly increases colorectal cancer (CRC) screening rates in underserved communities, according to the results of a new study. The randomized clinical trial, conducted at federally qualified health centers (FQHCs) across North Carolina, showed a threefold improvement in screening rates compared to usual care, highlighting the potential of centralized interventions to save lives.
The study enrolled 4,002 adults aged 50 to 75 who were overdue for CRC screening. Participants receiving the intervention were mailed FIT kits along with educational materials, prepaid return packaging, and reminder letters. Those with positive FIT results were guided through follow-up colonoscopy navigation. Within 6 months, 30% of participants in the intervention group completed CRC screening, compared to only 10% in the usual-care group.
The outreach was effective across all insurance types, including uninsured patients, emphasizing its broad applicability. Among those with positive FIT results, follow-up colonoscopy rates were 68.8% in the intervention group versus 44.4% in the control group. Importantly, the intervention led to the detection of advanced colorectal neoplasia in 1.4% of participants compared to 0.7% in the control group.
The findings underscore the value of centralized CRC screening programs in improving outcomes for diverse populations served by FQHCs. Future research should focus on scaling these interventions nationwide to address disparities in cancer prevention and early detection.
Reference: Reuland DS et al. Centralized colorectal cancer screening outreach in federally qualified health centers. JAMA Netw Open. 2024;7(11):e2446693.
