Mail-Back Test Aims To Improve Colorectal Cancer Screening Rates
The Division of Family & Community Medicine (DFCM) at University of Utah Health is part of a statewide initiative to improve colorectal cancer (CRC) screening rates and improve early detection efforts. Led by One Utah Health Collaborative, the Screen Utah initiative brings together more than 25 healthcare organizations to address and reverse Utah’s declining CRC screening rates by ensuring patients have access to the right test at the right time.
As Utah’s CRC screening rates fall below the national average, improving access and patient engagement in preventive care is more important than ever. According to a press release from One Utah Health Collaborative: “Colorectal cancer is the second leading cause of cancer-related death in the U.S., yet it is one of the most preventable with early detection. Despite this, Utah’s screening rates have dropped sharply—from 74% in 2020 to just 59.4% in 2022—underscoring the urgent need for action.”
Addressing Screening Barriers
The Screen Utah initiative aligns directly with a quality improvement (QI) project DFCM launched in the fall of 2022 at Greenwood Health Center. Primary care physicians Farrant Sakaguchi, MD, and Mehrnoosh Shakeri, MD, approached the QI team with the goal of improving CRC screening rates and addressing the long wait times for colonoscopy appointments through fecal immunochemical tests (FIT).
The division has expanded access to CRC testing by offering take-home, mail-back, FIT kits in 11 primary care clinics. Along with the FIT test, the kit includes a supplemental bag with instructions, a Q&A sheet, and a return label. FIT testing is a non-invasive alternative to colonoscopy and is designed to make CRC screening convenient and accessible. “FIT helps identify both high- and low-risk patients,” said Senior Quality Improvement Manager Emily Carlson.
With FIT testing aiding in early detection, providers can perform timely interventions by tracking positive FIT tests and collaborating with care management to ensure quick colonoscopy scheduling. “It's nice to see the impact,” said Carlson. “Patients who have a positive FIT test are getting colonoscopies quickly, which provides either peace of mind or a prompt diagnosis and treatment.”
Collaboration Across U of U Health
The FIT testing mail-back initiative is possible due to the collaboration across various health science disciplines and service areas including Gastroenterology, Huntsman Cancer Institute, Nursing, ARUP Laboratories, and University Print & Mail Services. The efforts made by these groups and countless individuals have streamlined the FIT testing mail-back process, to ultimately increase screening rates with the goal of improving patient outcomes.
After two years of testing and revising workflows, Carlson said it’s exciting to see the mail-back process come together while contributing to larger statewide efforts. “It's been amazing to see everybody align under one goal and say, ‘Let's do the best that we can for patients.’ That's why I really like quality improvement—because we can identify how to best serve the population.”