Colorectal cancer (CRC) is a common cause of cancer death and disproportionately affects non-Hispanic Black patients. Routine screening with the fecal immunochemical test (FIT) decreases CRC incidence and mortality, and previous literature suggests pairing FIT with live outreach. Screening delays due to the COVID-19 pandemic will likely increase CRC incidence and mortality, especially in underserved communities. We implemented a quality improvement (QI) project at an urban community health center (CHC) in which FIT was paired with live telephone outreach. The intervention increased CRC screening at the CHC by five percentage points. Fecal immunochemical test completion rates significantly increased with successful contact (24.6% for at least one vs. 3.0% for none, p < .0001) and ordering a FIT kit during a patient interaction (28.4% vs. 15.7%, p < .001). This intervention addressed disparities in CRC screening, and the report may have general implications for addressing systemic racism in preventive medicine.
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Background: Healthcare is a major contributor to global greenhouse gas emissions. Colorectal cancer (CRC) screening is one of the most widely used healthcare services in the US, indicated for approximately 134 million adults. Recommended screening options include fecal immunochemical tests (FITs) every year, CT colonographies (CTCs) every 5 years, or colonoscopies every 10 years.
View Article and Find Full Text PDFPractitioner perspectives on symptomatic faecal immunochemical testing: a qualitative interview study.
Br J Gen Pract
January 2025
Newcastle University, Population Health Sciences Institute, Newcastle upon Tyne, United Kingdom.
Background: Faecal Immunochemical Testing (FIT) is now core to the management of patients presenting in primary care with symptoms of possible colorectal cancer. Patients with a positive FIT (≥10μg Hb/g faeces) qualify for an urgent suspected cancer referral. FIT negative patients are typically managed in primary care or referred through routine pathways.
View Article and Find Full Text PDFDelays in Diagnostic Colonoscopy After Positive FIT in an Integrated Healthcare System.
Dig Dis Sci
January 2025
Division of Hospital and Specialty Medicine, Portland VA Medical Center, Portland, USA.
Background: Colorectal cancer screening with fecal immunochemical testing (FIT) is a process that depends on diagnostic colonoscopy for those with a positive test and completion of colonoscopy after positive FIT is an essential element of program effectiveness.
Aims: We examined how the COVID-19 pandemic influenced completion of diagnostic colonoscopy after positive FIT in our integrated healthcare system.
Methods: This was a retrospective study of all positive FIT over a 5-year period.
Cost-Effectiveness of Noninvasive Colorectal Cancer Screening in Community Clinics.
JAMA Netw Open
January 2025
Fred Hutchinson Cancer Research Center, Hutchinson Institute for Cancer Outcomes Research and Biostatistics Program, Public Health Sciences Division, Seattle, Washington.
Importance: Several noninvasive tests for colorectal cancer screening are available, but their effectiveness in settings with low adherence to screening and follow-up colonoscopy is not well documented.
Objective: To assess the cost-effectiveness of and outcomes associated with noninvasive colorectal cancer screening strategies, including new blood-based tests, in a population with low adherence to screening and ongoing surveillance colonoscopy.
Design, Setting, And Participants: The validated microsimulation model used for the decision analytical modeling study projected screening outcomes from 2025 to 2124 for a simulated cohort of 10 million individuals aged 50 years in 2025 and representative of a predominantly Hispanic or Latino patient population served by a Federally Qualified Health Center in Southern California.
Cost Effectiveness of Colorectal Cancer Screening Strategies in Middle- and High-Income Countries: A Systematic Review.
J Gastroenterol Hepatol
January 2025
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Background And Aim: Colorectal cancer (CRC) is a significant global health burden, and screening can greatly reduce CRC incidence and mortality. Previous studies investigated the economic effects of CRC screening. We performed a systematic review to provide the cost-effectiveness of CRC screening strategies across countries with different income levels.
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