Implementing an Organized Colorectal Cancer Screening Program: Lessons Learned From an Academic-Community Practice

Area of Science:

• Public Health
• Gastroenterology
• Health Services Research

Background:

• Mailed fecal immunochemical test (FIT) outreach can enhance colorectal cancer (CRC) screening effectiveness.
• Published real-world experiences on implementing organized CRC screening programs are limited.

Purpose of the Study:

• To synthesize the implementation process of an organized CRC screening program utilizing mailed FIT outreach.
• To share real-world experiences to potentially increase the adoption of similar programs.

Main Methods:

• A cross-institutional organized CRC screening program was developed in partnership with a population health team and primary care.
• Key elements defined included the institutional approach, target population, screening methods, team responsibilities, quality assurance, and cancer occurrence identification.
• The program workflow involved mailed postcards, MyChart messages, FIT kits, and reminders, with navigation for abnormal results.

Main Results:

• The program screened 9,719 eligible patients in its first year.
• An intention-to-treat analysis showed that 32% of patients completed CRC screening via FIT or colonoscopy.
• The program facilitated CRC screening through a structured outreach and follow-up process.

Conclusions:

• Broad dissemination of pilot data, early institutional support, robust data management, and strong interdepartmental collaboration were crucial for successful implementation.
• This real-world experience provides a model for establishing organized CRC screening programs.
• Successful implementation can lead to improved CRC screening rates and patient benefit.