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Multicomponent intervention with mailed FIT and navigation increased colorectal cancer screening uptake in Federally Qualified Health CentersMailed FIT tests and navigation boost cancer screening in community clinics

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Key Takeaway
Consider broad implementation of mailed FIT and navigation to improve colorectal cancer screening disparities 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.

A large study in Federally Qualified Health Centers tested a two-part plan to get more patients screened for colorectal cancer. Patients who were due for screening got a mailed fecal immunochemical test (FIT) kit. If the test was positive, they received patient navigation to help them complete a follow-up colonoscopy.

The main result was a big jump in screening. About 18% more patients in the intervention group completed screening compared to the control group. This benefit was seen across all racial and ethnic groups studied.

Hispanic patients saw a 16.7% increase in screening. Non-Hispanic Black patients had a 13.9% increase. Non-Hispanic White patients had a 20.7% increase. The study found no significant difference in the benefit between these groups.

The approach is practical and can be used in many community clinics. It helps address gaps in cancer screening for minoritized populations. The study did not report on safety issues or side effects.

What this means for you:
Mailed FIT tests plus patient navigation significantly increased colorectal cancer screening in community health centers.

Study Details

Study typeRct
Sample sizen = 3,734
EvidenceLevel 2
PublishedMay 2026
View Original Abstract ↓
Racially and ethnically minoritized patients are underscreened for colorectal cancer (CRC), resulting in racial/ethnic disparities. This secondary analysis of a pragmatic patient-randomized clinical trial compared effects of a CRC intervention across race/ethnicity. The multicomponent intervention included a mailed fecal immunochemical test (FIT) for patients in Federally Qualified Health Centers due for screening, plus patient navigation for positive FITs. Among 3,734 patients, 9.7% identified as Hispanic, 29.0% as non-Hispanic Black, and 61.3% as non-Hispanic White, similar across intervention and control arms ( = .73). The adjusted risk difference (RD) for CRC screening uptake between arms was 18.3% (95% CI, 15.6%-20.9%). In stratified analysis, adjusted RDs were 16.7% (95% CI, 7.5%-25.9%) for Hispanic patients, 13.9% (95% CI, 8.6%-19.0%) for non-Hispanic Black patients, and 20.7% (95% CI, 17.2%-24.1%) for non-Hispanic White patients, which did not differ significantly (interaction = .79). Because the intervention effect did not differ by race/ethnicity, broad implementation among minoritized populations could improve CRC screening disparities.
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