Flatbush FHC Proactive Colorectal Cancer Screening and Navigation

The proposed study is a randomized controlled pilot trial designed to assess the effectiveness and acceptability of a proactive screening outreach program on colorectal cancer screening rates on eligible patients in the Flatbush Family Health Center medical practice, which provides free and subsidized health services to underrepresented minorities. The investigators will randomize patients to the proactive screening outreach arm which will include mailed letters providing patients with information regarding their eligibility for and instructions for performing colorectal cancer screening with FIT testing or colonoscopy. Colorectal cancer screening rates via FIT testing or colonoscopy will be compared in the proactive outreach group and the usual care group. The investigators hypothesize that rates of colorectal cancer screening will improve in underserved populations with the implementation of a proactive approach that incorporates a mailed outreach invitation to screen, followed by active assistance to a colonoscopy completion if preferred or indicated.

Inclusion criteria

• Receiving medical care at Flatbush FHC
• Due or overdue for CRC screening

Exclusion criteria

• Age younger than 45 years old or greater than 75 years old
• Up-to-date with colorectal cancer screening (FIT within 1 year or colonoscopy within 10 years)
• History of colorectal cancer, inflammatory bowel disease or colorectal polyps
• No address or phone number on file
• FIT test ordered within 6 months