Multicomponent intervention with mailed FIT and navigation increased colorectal cancer screening uptake in Federally Qualified Health Centers

This pragmatic patient-randomized clinical trial secondary analysis examined patients at Federally Qualified Health Centers. The sample size was 3,734 individuals. The intervention included a mailed fecal immunochemical test for patients due for screening plus patient navigation for positive FITs, compared with a control arm.

The primary outcome was colorectal cancer screening uptake. The adjusted risk difference was 18.3% (95% CI, 15.6%-20.9%). Subgroup analyses showed an adjusted risk difference of 20.7% (95% CI, 17.2%-24.1%) for non-Hispanic White patients, 16.7% (95% CI, 7.5%-25.9%) for Hispanic patients, and 13.9% (95% CI, 8.6%-19.0%) for non-Hispanic Black patients. The interaction by race or ethnicity did not differ significantly (interaction = .79).

Safety and tolerability data were not reported. Adverse events, serious adverse events, discontinuations, and tolerability were not reported. The study phase was not reported. Funding or conflicts of interest were not reported.

The practice relevance suggests broad implementation among minoritized populations could improve colorectal cancer screening disparities. The study design and lack of reported causality notes require cautious interpretation of the findings.