Colorectal Cancer Screening with Programmatic Mailed FIT
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Screening is proven to reduce mortality from colorectal cancer (CRC), the second leading cause of cancer death in the United States. Unfortunately, hundreds of thousands of Veterans are unscreened, and the COVID-19 pandemic has exacerbated this problem, with approximately 1.6 million Veterans due for screening in 2021. To address this still-growing backlog, we have initiated a program to mail Fecal Immunochemical Test (FIT) kits for CRC screening directly to our Veterans to use in their homes and mail back for analysis; Veteran and provider acceptance have been very positive.
We believe our FIT-first approach, modeled after the successful Kaiser Permanente program, will increase CRC screening adherence, reduce overall costs, increase colonoscopy access for Veterans with the highest risk for CRC, and ultimately save lives.
Origin:
February 2021, VISN-21
Adoptions:
5 successful, 6 in-progress
Awards and Recognition:
SCOPY Award Winner, American College of Gastroenterology, Diffusion of Excellence Promising Practice, VHA Shark Tank Winner
Partners:
Gastroenterology and Hepatology, Office of Primary Care, Oncology, Pathology and Laboratory Medicine Service
Recent Updates
Overview
The problem
The solution
Our program is simple. Utilizing reports from the national CRC Screening and Surveillance Reminder System, Veterans who are currently due or overdue for average risk CRC screening are mailed a FIT kit to use in their home. Veterans then send samples directly to their local VHA for analysis. Positive samples are then referred to the Veteran’s primary care provider for appropriate follow-up. See more
Links
- Toolkit for VISNs and VA Medical Centers interested in replicating VHA Internal Mailed FIT SharePoint
The results
In Las Vegas to date, 43.1% of Veterans have returned their FIT kit, of whom 24, or 5.3%, have tested positive.
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Departments
- Gastroenterology
- Logistics
- Laboratory and pathology
- Primary care
Contact
Comment
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About
Original team
Chris Moore, MPH
Project Coordinator
Jason Dominitz, MD, MHS
Executive Director, National Gastroenterology and Hepatology Program
i would also like more information in adopting this innovation
I would to hear an update on this and how to adopt this innovation
I want to adopt this innovation
Thanks for your interest, Patricia!
We would be interested to hear an update on how other facilities are doing ni adopting this innovation.
The National Center for Health Promotion is excited about this innovation which provides a highly scalable, evidence-based strategy for enhancing Colorectal Cancer (CFC) Screening, reducing the backlog of Veterans who are due for CRC screening, and ultimately reducing morbidity and mortality due to CRC. This innovation builds upon existing VHA resources and offers a highly cost-efficient approach that also reduces burden on front-line clinicians who are struggling to address care needs of Veterans during the pandemic. The developers of this intervention have created incredibly useful tools for educating Veterans and making it easy for them to participate in screening. This innovation should be adopted enterprise wide - ideally coordinated at the VISN level!