• Sean P McClellan, Shreya Patel, Elizabeth Uy-Smith, Blake Gregory, John M Neuhaus, Michael B Potter, and Ma Somsouk.
• From the Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA; Division of Gastroenterology, Zuckerberg San Francisco General Hospital, San Francisco, CA; San Francisco Health Network, San Francisco, CA; and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA. smccle2@uic.edu.
• J Am Board Fam Med. 2024 Jul 1; 37 (4): 660670660-670.

PurposeColorectal cancer (CRC) screening is recommended starting at age 45, but there has been little research on strategies to promote screening among patients younger than 50. This study assessed the effect of a multicomponent intervention on screening completion in this age group.MethodsThe intervention consisted of outreach to patients aged 45 to 49 (n = 3,873) via mailed fecal immunochemical test (FIT) (sent to 46%), text (84%), e-mail (53%), and the extension to this age group of an existing standing order protocol allowing primary care nurses and medical assistants to order FIT at primary care clinics in an urban safety-net system. We used segmented linear regression to assess changes in CRC screening completion trends. Patients aged 51 to 55 were included as a comparison group (n = 3,943). Data were extracted from the EHR.ResultsThe percentage of patients aged 45 to 49 who were up-to-date with CRC screening (colonoscopy in 10 years or FIT in last year) increased an average of 0.4% (95% CI 0.3, 0.6)) every 30 days before intervention rollout and 2.8% (95% CI 2.5, 3.1) after (slope difference 2.3% [95% CI 2.0, 2.7]). This difference persisted after accounting for small changes in the outcome observed in the comparison group (slope difference 1.7% [95% CI 1.2, 2.2]).ConclusionsThese results suggest that the intervention increased CRC screening completion among patients 45 to 49. Health care systems seeking to improve CRC screening participation among patients aged 45 to 49 should consider implementing similar interventions.© Copyright by the American Board of Family Medicine.

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