Equitable Implementation of Mailed Stool Test-Based Colorectal Cancer Screening and Patient Navigation in a Safety...

Area of Science:

• Public Health
• Health Services Research
• Cancer Screening

Background:

• Mailed stool testing programs are vital for increasing colorectal cancer (CRC) screening.
• Understanding demographic uptake differences is crucial for health equity.
• Federally Qualified Health Centers (FQHCs) serve diverse, underserved populations.

Purpose of the Study:

• To evaluate the uptake and equity of a mailed stool test program in a Central Texas FQHC system.
• To assess colorectal cancer screening completion rates across demographic groups.

Main Methods:

• Retrospective cohort study of patients aged 50-75 at average CRC risk within an FQHC system.
• Mailed outreach included fecal immunochemical tests (FIT), instructions, and reminders.
• Patient navigation facilitated colonoscopy for positive FIT results.

Main Results:

• 19.9% of 33,606 patients completed mailed FIT; 5.6% tested positive.
• 72.5% of those with positive FIT completed colonoscopy.
• Hispanic/Latinx, Spanish-speaking, and uninsured patients showed higher FIT completion rates and equitable colonoscopy follow-up.

Conclusions:

• Mailed FIT outreach with navigation effectively increased CRC screening in an FQHC setting.
• The program demonstrated equitable reach across diverse demographic groups.
• This approach can improve colorectal cancer screening for underserved populations.