Targeted QI Initiative Improves CRC Screening Uptake

A quality improvement initiative using fecal immunochemical testing (FIT) and colonoscopy was able to improve colorectal cancer (CRC) screening uptake in a managed care setting, according to a poster presented at Digestive Disease Week 2017.

 “CRC is a common but largely preventable disease. Despite national guidelines that support screening for individuals aged 50 to 75, screening rates are suboptimal in large managed care populations,” Christine Yu, gastroenterology fellow at UCLA Health, and colleagues wrote. “Single-component interventions aimed to improve uptake of CRC screening only modestly improve screening rates. There is strong evidence for multimodal interventions that simultaneously address patient-, provider-, and system-level barriers to screening in health care systems.”

In order to determine the impact of a multimodal intervention on CRC screening uptake, the researchers designed a quality improvement program that targeted 5186 unscreened managed care patients. They mailed targeted patients CRC screening information, CRC screening options (specifically FIT and colonoscopy), and a FIT kit. Patients were encourage to return the completed FIT test via mail or to visit their primary care provider for a colonoscopy. 

Study results showed that 32.6% of study participants completed the FIT test or received a colonoscopy within 1 year of receiving the mailers. The researchers found that 20.8% completed the FIT test, while 11.8% received a colonoscopy. Screening rates in the managed care population rose from 64.4% to 76% as a result of the quality improvement intervention. 

“In managed care and academic hospital settings, where patient populations are diverse and face various barriers to CRC screening, it is difficult to identify interventions that improve screening uptake,” Ms Yu and colleagues concluded. “We demonstrate that a FIT-based intervention... can simultaneously address several barriers to screening and increase CRC screening uptake.”—David Costill