Mailed FIT Outreach to Improve Colon Cancer Screening in the Safety-net System
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Colorectal Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 50 - 75 |
| Updated: | 7/1/2018 |
| Start Date: | January 1, 2016 |
| End Date: | November 2019 |
Uptake of colorectal cancer (CRC) screening is suboptimal in the San Francisco Health Network
and access to care may be limited so novel models of health care delivery are warranted. The
objective of this study is to examine whether a centralized panel management model with
mailed fecal immunochemical test (FIT) will be effective at increasing the uptake of CRC
screening and could be developed and sustained within the typical parameters of
cost-effectiveness and budget impact analyses.
and access to care may be limited so novel models of health care delivery are warranted. The
objective of this study is to examine whether a centralized panel management model with
mailed fecal immunochemical test (FIT) will be effective at increasing the uptake of CRC
screening and could be developed and sustained within the typical parameters of
cost-effectiveness and budget impact analyses.
Rationale: Since uptake of colorectal cancer (CRC) screening is suboptimal in the SF
safety-net system and access to care may be limited, novel models of health care delivery are
warranted. The overall hypothesis is that a centralized panel management model with mailed
fecal immunochemical test (FIT) will be effective at increasing the uptake of CRC screening
and could be developed and sustained within the typical parameters of cost-effectiveness and
budget impact analyses. Barriers to immunization of adults include missed opportunities
during visits, limited access to providers, and provider and patient beliefs of efficacy.
Design: To rigorously examine the benefit of the centralized panel management to improve
uptake of CRC screening with mailed FIT, the electronic health system will be used to
identify eligible patients who are not up-to-date with CRC screening. Broadly, patients will
be randomized 1:1 to usual care or intervention arm, stratified by clinic, gender, prior
screening, and race to receive mailed FIT kits + usual care versus usual care alone. The
cost-effectiveness of no screening, usual care, and centralized management with mailed FIT
outreach will be compared using mathematical simulation models.
safety-net system and access to care may be limited, novel models of health care delivery are
warranted. The overall hypothesis is that a centralized panel management model with mailed
fecal immunochemical test (FIT) will be effective at increasing the uptake of CRC screening
and could be developed and sustained within the typical parameters of cost-effectiveness and
budget impact analyses. Barriers to immunization of adults include missed opportunities
during visits, limited access to providers, and provider and patient beliefs of efficacy.
Design: To rigorously examine the benefit of the centralized panel management to improve
uptake of CRC screening with mailed FIT, the electronic health system will be used to
identify eligible patients who are not up-to-date with CRC screening. Broadly, patients will
be randomized 1:1 to usual care or intervention arm, stratified by clinic, gender, prior
screening, and race to receive mailed FIT kits + usual care versus usual care alone. The
cost-effectiveness of no screening, usual care, and centralized management with mailed FIT
outreach will be compared using mathematical simulation models.
Inclusion Criteria:
- Asymptomatic men and women
- 50 to 75 years of age
Exclusion Criteria:
- Personal history of polyps requiring colonoscopic surveillance
- Homeless
- Severe co-morbidities limiting life expectancy e.g., advanced stage cancer
We found this trial at
1
site
San Francisco, California 94101
Principal Investigator: Ma Somsouk, MD
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