Colorectal cancer is preventable with screenings such as colonoscopy and fecal immunochemical tests, but only 66% of the U.S. population was up to date in 2018. The percentage dips lower at 44% in federally qualified health centers, which serve low-income, racially diverse populations. Home-based, self-administered colorectal cancer screening programs have been shown to reach broader and more diverse populations than in-office screening and may reduce disparities among populations that are disproportionately affected. However, sample return rates vary widely by patient, type of screening intervention and clinic characteristics.
In a new study, patients in 15 clinics within one urban FQHC participated in a trial aimed at optimizing colorectal cancer screening. Each patient was mailed a fecal immunochemical test (FIT) to be performed at home and returned to the doctor’s office via mail or in person. Researchers examined clinic-level factors associated with higher and lower FIT completion rates, including staffing patterns, availability of educational materials, and the availability of on-call patient support and troubleshooting. Clinics with higher FIT completion rates were found to have added staff to support the effort; provided patients with staff-led education upon providing FIT tests; or helped patients resolve barriers to FIT screening. Clinics with lower rates of FIT completion were found to be lacking in such support. The researchers concluded that adding non-physician staff to support patients throughout the entire screening process may help improve the return rate of FIT screenings and reduce the rate of colorectal cancer-related illness and death in populations who are disproportionately affected by the disease.
Clinic Factors Associated With Mailed Fecal Immunochemical Test (FIT) Completion: The Difference-Making Role of Support Staff
Melinda M. Davis, PhD, et al
Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon
https://www.doi.org/10.1370/afm.2772
The Annals of Family Medicine