Fecal Immunochemical Test Outreach for Colorectal Cancer Screening in Community Health Centers: A Randomized Clinical Trial

Importance: Colorectal cancer (CRC) screening is suboptimal among people in traditionally underserved populations, many of whom receive primary care at federally qualified health centers (FQHCs). Mailed fecal immunochemical test (FIT) outreach improves screening, especially in underserved populations, but questions remain about impact over time.

Objective

To evaluate the effectiveness of centralized annual mailed FIT outreach delivered over 3 years to increase CRC screening in FQHCs. Design, setting, and participants: This cluster randomized clinical trial was conducted between June 1, 2021, and May 31, 2024. Sixteen clinics from 2 FQHCs in Southern California were randomly assigned to mailed FIT outreach or usual care for patients aged 50 to 75 years and not up to date with screening.