Colorectal cancer screening is an effective tool for catching the disease early when it’s most treatable, yet it is underutilized in patient populations who receive primary care at federally qualified health centers (FQHC).
A new study by researchers at UNC Lineberger Comprehensive Cancer Center demonstrated that a targeted intervention can substantially increase screening rates in patients who are not current with recommended screening. The researchers report in JAMA Network Open that mailing at-home colorectal cancer screening kits and providing coordinated follow-up led by an academic cancer center tripled screening completion rates compared to usual care at FQHCs.

Previous research has shown this kind of intervention is effective in large, integrated health systems. However, its impact was unknown in FQHCs, which operate as small, grant-funded entities that are often under-resourced and serve as safety-net care providers. Daniel Reuland, MD, MPH, the study’s corresponding author and professor of medicine in the Division of General Medicine & Clinical Epidemiology, said increasing the screening rate at FQHCs, which provide care to 1 in 11 people in the United States, could reduce the rate of colorectal cancer incidence and death and improve the care of many underserved populations.
“Reaching a largely unscreened, predominantly low-income population using centralized mailed screening kits and patient navigation for those with abnormal tests can substantially increase guideline-recommended colorectal cancer screening in federally qualified health centers,” said Reuland, the Robert A. Ingram Distinguished Professor at UNC School of Medicine and co-director of the UNC Lineberger Carolina Cancer Screening Initiative (CCSI).