Mailed Screening Kits Help Reduce Colorectal Cancer Screening Gaps

Colorectal cancer screening is a longstanding preventive priority, yet participation and follow-up remain uneven across patient groups. Safety‑net primary care settings often face barriers that limit screening uptake among underserved populations. Addressing these gaps is essential to reduce disparities in outcomes. New findings demonstrate that mailing an at‑home stool test can substantially increase screening across diverse racial and ethnic groups.

At the University of North Carolina at Chapel Hill School of Medicine, investigators evaluated mailed fecal immunochemical tests (FIT) to increase colorectal cancer screening. The approach centered on sending FIT kits to patients due for screening at federally qualified health centers (FQHCs). For positive FIT results, the study team provided patient navigation to support follow‑up colonoscopy.

Image: New findings show that mailed at-home stool tests can substantially increase screening across diverse racial and ethnic groups (image credit: Adobe Stock)

The analysis drew on data from two FQHC systems in North Carolina. A total of 3,734 patients were mailed FIT kits and participation in screening was assessed. Researchers reported an overall increase of 18.3 percentage points in colorectal cancer screening associated with the mailed‑test intervention.

Screening gains were similar among Hispanic, non‑Hispanic Black, and non‑Hispanic white patients. Among patients with a positive FIT who required follow‑up colonoscopy, the intervention’s effect was also similar across racial groups. However, Black patients were overall less likely to complete colonoscopy than white patients, indicating a need for additional, targeted strategies to support follow‑up among this population.

Results were published in the Annals of Family Medicine. The study team emphasized that mailed FIT programs can reach patients across demographic groups in community health settings while also highlighting persistent differences in colonoscopy completion that warrant focused interventions.

“This analysis showed that mailed colorectal cancer screening tests have the power to improve screening rates for diverse populations. This is really important, because we want these innovations in screening to improve outcomes among the hardest to reach populations and move the needle on colorectal cancer disparities,” said Anisha P. Ganguly, MD, MPH, a general internist at UNC Health and member of UNC Lineberger Comprehensive Cancer Center.

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