Enhancing CRC Screening in a Predominantly Hispanic Community: Effectiveness of 1-Day vs. 3-Day Stool-Based Testing...

Area of Science:

• Public Health
• Gastroenterology
• Health Disparities

Background:

• Colorectal cancer (CRC) is a leading cause of cancer mortality among U.S. Hispanics, a demographic with disproportionately low screening rates.
• Stool-based screening tests, such as the Fecal Immunochemical Test (FIT), are effective in reaching underserved populations and improving adherence.
• Optimizing FIT kit protocols may enhance screening completion rates within vulnerable communities.

Purpose of the Study:

• To evaluate the comparative performance of 1-day versus 3-day FIT kits in a Hispanic community along the U.S.-Mexico border.
• To assess the impact of different FIT kit durations on screening completion rates and the need for reminder calls.
• To identify strategies for improving CRC screening adherence among uninsured or underinsured Hispanic individuals.

Main Methods:

• A quasi-experimental observational study involving 6,660 uninsured or underinsured Hispanic participants aged 45-75 overdue for CRC screening.
• Participants received CRC education and no-cost stool-based screening facilitated by community health workers (promotoras).
• Random assignment to either a 1-day or 3-day FIT kit, with a crossover of distribution roles to mitigate bias.

Main Results:

• The 1-day FIT kit demonstrated a significantly higher return rate (61.3% vs. 58.7%, aOR=1.22, p<0.001).
• Fewer reminder calls were required for the 1-day FIT kit group (69.7% vs. 78.1%, aOR=0.65, p<0.001).
• The 1-day FIT kit also showed a lower rate of abnormal results (5.3% vs. 8.1%, aOR=0.61, p<0.001).

Conclusions:

• The 1-day FIT kit significantly improved screening return rates and reduced the need for follow-up reminders in this Hispanic population.
• This shorter protocol may be a more effective strategy for increasing colorectal cancer screening completion among hard-to-reach Hispanic communities.
• Further research should explore the scalability and long-term impact of 1-day FIT kits in diverse, underserved populations.