Open AccessMailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention–sponsored Summit
Author(s) -
Gupta Samir,
Coronado Gloria D.,
Argenbright Keith,
Brenner Alison T.,
Castañeda Sheila F.,
Dominitz Jason A.,
Green Beverly,
Issaka Rachel B.,
Levin Theodore R.,
Reuland Daniel S.,
Richardson Lisa C.,
Robertson Douglas J.,
Singal Amit G.,
Pig Michael
Publication year - 2020
Publication title -
ca: a cancer journal for clinicians
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 62.937
H-Index - 168
eISSN - 1542-4863
pISSN - 0007-9235
DOI - 10.3322/caac.21615
Subject(s) - outreach , champion , medicine , colorectal cancer screening , family medicine , cancer prevention , test (biology) , return on investment , medical education , disease control , colonoscopy , colorectal cancer , cancer , environmental health , political science , paleontology , macroeconomics , production (economics) , law , economics , biology
Uptake of colorectal cancer screening remains suboptimal. Mailed fecal immunochemical testing (FIT) offers promise for increasing screening rates, but optimal strategies for implementation have not been well synthesized. In June 2019, the Centers for Disease Control and Prevention convened a meeting of subject matter experts and stakeholders to answer key questions regarding mailed FIT implementation in the United States. Points of agreement included: 1) primers, such as texts, telephone calls, and printed mailings before mailed FIT, appear to contribute to effectiveness; 2) invitation letters should be brief and easy to read, and the signatory should be tailored based on setting; 3) instructions for FIT completion should be simple and address challenges that may lead to failed laboratory processing, such as notation of collection date; 4) reminders delivered to initial noncompleters should be used to increase the FIT return rate; 5) data infrastructure should identify eligible patients and track each step in the outreach process, from primer delivery through abnormal FIT follow‐up; 6) protocols and procedures such as navigation should be in place to promote colonoscopy after abnormal FIT; 7) a high‐quality, 1‐sample FIT should be used; 8) sustainability requires a program champion and organizational support for the work, including sufficient funding and external policies (such as quality reporting requirements) to drive commitment to program investment; and 9) the cost effectiveness of mailed FIT has been established. Participants concluded that mailed FIT is an effective and efficient strategy with great potential for increasing colorectal cancer screening in diverse health care settings if more widely implemented.