Scaling CRC Screening Through Outreach, Referral, and Engagement (SCORE)
Colorectal cancer (CRC) is a leading cause of cancer death in the United States. In North Carolina, as in many parts of the United States, CRC screening is substantially underused in vulnerable and marginalized populations. Uninsured, underinsured, and medically underserved populations rely on federally qualified health centers (FQHCs) for their healthcare and thus patients served by North Carolina's FQHCs are particularly likely to benefit from efforts and resources to improve CRC screening. The United States Preventive Services Task Force recommends several tests to screen for CRC, including annual screening with a fecal immunochemical test (FIT), for patients ages 50-75 years. Programs that include mailing FITs to patients have shown promise as an effective means of increasing CRC screening, including for vulnerable populations. This randomized controlled trial is designed to assess the effectiveness, feasibility, acceptability, and cost-effectiveness of mailing FITs from a central location to patients served by FQHCs. This study also assesses the effectiveness, feasibility, acceptability, and costs of delivering patient navigation from a central location to facilitate follow-up colonoscopy for patients with a positive (abnormal) FIT result. To assess adherence to the United States Preventive Services Task Force recommendations for annual screening with FIT, we will mail eligible participants one FIT per year for up to two years.
Start: July 2020