Common Keyword: FIT/gFOBT

Fecal immunochemical test/guaiac-based fecal occult blood test

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flu FIT
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FluFIT Program

FluFIT programs increase colorectal cancer screening rates by providing a take home fecal immunochemical test (FIT) to eligible patients when they receive their annual flu shot. Thus, the annual flu shot campaign create an opportunity to reach people who are also due for colorectal screening.

The FluFIT website offers program planning and implementational materials, including staff training, work flows, log sheets, sample reminder letters, and sample telephone call scripts. The site also provides patient educational materials, such as clinic posters, and FIT instructions (both printed materials and videos) in several languages. These materials can help prepare a healthcare team to develop the simple systems needed to implement a FluFIT program and jump start program development.

FluFIT programs have been implemented successfully in a variety of clinical settings. Many FluFIT campaigns are run by nurses, pharmacists, or medical assistants. They can be implemented and sustained with limited resources, are well accepted by patients, and can lead to higher screening rates.

Evaluation: FluFIT is a research-tested program. Visit the Publications section of the website to find research articles and reviews of the FluFIT approach.

Evaluation Assets: The Program Materials section of the website includes a sample FluFIT log sheet and sample FluFIT results tracking sheet.

Permissions: Made publicly available online by the Department of Family and Community Medicine, University of California.

Publication date: 2009; updated in 2017

Post date: September 15, 2017

Contact: Send comments, questions, and suggestions to Michael Potter, MD at potterm@fcm.ucsf.edu.

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Primary Care Physicians
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What Can Primary Care Physicians Do To Advance 80% By 2018?

Learn how primary care physicians can be part of the national effort to make sure 80% of adults ages 50 and older are regularly screened for colorectal cancer by 2018.

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Guidance On Implementing FIT-Based Screening Programs

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Guidance on Implementing FIT-based Screening Programs – June 29, 2016

This webinar reviewed the rationale for FIT-based testing programs, discussed implementation strategies, and reviewed possible solutions to common barriers to FIT programs.

Speakers:

  • Durado Brooks, MD, MPH, American Cancer Society
  • Gloria Coronado, PhD, Kaiser Permanente Center for Health Research
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US Preventive Services Task Force
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Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement

The US Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for people at average risk and with no signs or symptoms of the specific disease or condition under evaluation. Recommendations are assigned a letter grade (A, B, C, or D grade or I statement) based on the strength of the evidence and the balance of benefits and harms of a preventive service. Costs of services are not considered in the evaluation.

In 2016, the USPSTF released a new “A” grade Final Recommendation Statement for colorectal cancer screening, which recommends screening for colorectal cancer starting at age 50 and continuing until age 75 years with one of several screening strategies. One of the primary differences from the 2008 recommendation is the addition of computed tomography (CT) colonography and multitargeted stool DNA (FIT-DNA) to the list of screening strategies.

Evaluation: The USPSTF is comprised of volunteer members who are nationally recognized experts in prevention, evidence-based medicine, and primary care. The USPSTF bases its recommendations on the strength of the evidence and the balance of benefits and harms of a preventive service. This recommendation statement was also published in the peer-reviewed journal JAMA.

Permissions: Made publicly available online by the US Preventive Services Task Force.

Publication date: June 2016

Post date: September 15, 2017

Contact: Submit comments, questions, and suggestions via web form.

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action steps for health plans
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The Importance of Waiving Cost-sharing for Follow-up Colonoscopies: Action Steps for Health Plans

The Affordable Care Act (ACA) eliminates cost-sharing for United States Preventive Services Task Force (USPSTF) – recommended preventative services for individuals who are privately insured, including screening for colorectal cancer by high sensitivity stool test or colonoscopy for adults ages 50 and 75.* Some health plans, however, apply cost-sharing to colonoscopies that follow a positive stool test. This creates a financial incentive for patients to select the more costly and invasive colonoscopy as their initial test. Additionally, this cost-sharing creates a financial disincentive that may lead patients to forego the follow-up test that they need.

This Issue Brief gives an overview of this issue and makes a request to health plans to waive cost-sharing for members when colonoscopy is ordered as follow-up to a positive stool test or other colorectal cancer screening test, just as cost-sharing is waived for colonoscopy when it is selected as the first-line screening exam.

Learn more in Colorectal Cancer Screening Best Practices Handbook for Health Plans, a compilation of best practices, case studies, templates and tools.

*The ACA preventive services requirements do not apply to “grandfathered” health plans that were in existence prior to March 23, 2010, as long as such plans continue to meet certain standards for grandfathered plans.

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stopcrc
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Screen to Prevent (STOP) Colon Cancer

The Screen to Prevent (STOP) Colon Cancer project works to raise colorectal cancer screening rates in Federally Qualified Health Centers (FQHCs) in California, Oregon, and Washington State using fecal immunochemical testing (FIT).

The five-year project evaluates the effectiveness of the program in real-life practice conditions and is led by scientists and physicians at Kaiser Permanente’s Center for Health Research, Group Health Research Institute, and OCHIN. The project is funded by the National Institutes of Health Common Fund Health Care Systems (HCS) Research Collaboratory program.

Visit the Materials section of the website to find a variety of downloadable educational materials, including wordless instructions for multiple FITs, reminder and results letters, clinic posters, and workflow job aid templates.

Evaluation: The project began with a pilot study that found significant improvements in FIT completion rates for clinics in the STOP intervention. Visit the Findings section of the website to learn more.

Permissions: Made publicly available online by Kaiser Permanente Center for Health Research.

Publication date: 2014

Post date: September 20, 2017

Contact: Send comments, questions, and suggestions to Amanda.F.Petrik@kpchr.org.

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Steps For Increasing Colorectal Cancer Screening Rates: A Manual For Community Health Centers

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Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Community Health Centers – September 11, 2014

This webinar introduced the new resource, Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Community Health Centers.

Speakers:

  • Richard Wender, MD, American Cancer Society
  • Mary Doroshenk, MA, NCCRT
  • Maria Syl D. del la Cruz, MD, Thomas Jefferson University
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CHC manual
Download the 2014 Edition

Note: The NCCRT released a 2022 update to the Steps Guide in September 2022. The 2014 version is available for historical reference only. View the 2022 Steps Guide. 

Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Community Health Centers

The NCCRT released a 2022 update to the Steps Guide in September 2022. 

This manual provides step-by-step instructions to help community health centers implement processes that will reduce physician workload and increase colorectal cancer screening. Important topics, such as conducting baseline screening rates, assessing capacity and preparing your team are covered. The goal of this manual is to offer practical advice for implementing expert-endorsed recommendations one step at a time.

The manual is organized into three primary sections: 1) An Introduction that provides information on the importance of colorectal cancer screening; 2) Steps to Increase Cancer Screening Rates, which maps out a plan for improving your screening rates and gives step by step instructions for doing so; and 3) The Appendices, which provides field-tested tools, templates, and resources to get you started.

We suggest that you use the manual in segments, focusing on the three or four pages of information you need at a time, and make good use of the appendices, which have several templates, tools, and resources to save you time.

If you use the live links throughout the manual, you can get back to where you were by pressing “Alt+Left Arrow” on a PC or “Command+Left Arrow” on a Mac.

View the September 11, 2014 webinar introducing the new manual.

The manual serves as a supplement to the existing How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician’s Evidenced based Toolbox and Guide.

 

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How to Increase Preventive Screening Rates in Practice
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How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician’s  Evidenced-Based Toolbox and Guide

The CRC Clinician’s Guide and slide set is a practical guide for primary care clinicians containing evidenced-based tools, sample templates and strategies that can help practices improve their screening performance. A printable slide set is available for download. For PowerPoint version please contact us.

An interactive, online version of CRC Clinician’s Guide has been launched to offer an interactive, web-based version of the CRC Evidence Based Toolkit and Guide that can walk physicians through the contents of the Guide in an interactive, online format. Also available is a CA Journal article, “How to Increase Colorectal Cancer Screening Rates in Practice,” which provides a quick overview of the evidence in the Guide, and a CRC Clinician’s Guide brochure, which is a quick one-page overview of the Guide that can be emailed or downloaded and printed.

Colorectal Cancer Screening Clinician’s Guide: Cancer Screening Action Plan. This shorter version of the Colorectal Cancer Screening Clinician’s Toolbox and Guide was designed for busy clinicians after collecting extensive feedback from physicians on the original Guide. The most important material from the full Guide was condensed into a step by step tool that still offers an expansive collection of the most relevant charts, templates and sample materials that clinicians can put to use.

To access this new tool click here.

Options for Increasing Colorectal Cancer Screening Rates in Community Health Centers. In addition, researchers from the University of North Carolina Lineberger Comprehensive Cancer Center, have recently adapted the CRC Clinician’s Guide for use in the Community Health Center setting.

To access this specialized tool click here.

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ACS
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American Cancer Society Recommendations for Colorectal Cancer Early Detection

The American Cancer Society creates guidelines for the prevention and early detection of  cancer, including colorectal cancer, as well as guidelines for screening and surveillance for individuals at increased or high risk of the disease.

The ACS’s 2008 recommendations were issued in a joint guideline, Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. They recommend adults at average risk for the disease begin screening starting at age 50 with a menu of screening options. The recommendations provide benefits and limitations associated with each test to aid in making an informed decision. The webpage also includes additional links to tools and resources for patients and clinicians.

Evaluation: The guidelines were developed in collaboration with experts from the American Cancer Society, the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology. Learn more in the Guidelines Development, Methods, And Framework section of the joint guideline. This recommendation statement was also published in the peer-reviewed journal CA: A Cancer Journal for Clinicians.

Permissions: Made publicly available online by the American Cancer Society.

Publication date: 2008

Post date: September 15, 2017

Contact: Submit comments, questions, and suggestions via web form.