Opportunistic Colorectal Cancer Screening: Providing FIT with Annual Flu Shots

Background

Colorectal cancer (CRC) is preventable or curable when detected early, but, because screening is underused, it remains the second leading cause of cancer death in the US. One CRC screening method is with fecal immunochemical testing (FIT), a simple and inexpensive annual home test that is recommended for patients age 50 and older. Preliminary studies indicate that many individuals who get annual flu shots have not had or are not up to date with CRC screening.

##Specific aims

1. To determine whether offering FIT in the context of HMO-sponsored flu vaccine campaigns is an effective method to increase CRC screening activities among adults aged 50 and older

2. To develop time-efficient, cost-effective, sustainable, nurse-driven systems to support the provision and completion of annual FIT.

##Methods

The project will take place at Kaiser Permanente Santa Clara (KPSCL), a facility which annually provides flu shots to about 50,000 adults over age 50, approximately 20,000 of whom are typically overdue for colorectal cancer screening. The researchers will work with KPSCL personnel to develop procedures to assess patient eligibility for CRC screening during flu vaccine clinics using computerized medical records, develop trainings to support KPSCL staff to offer FIT during flu vaccine clinics, develop multilingual patient education materials and FIT instructions, and use these resources to implement a "FLU-FIT" campaign for KPSCL in the fall of 2008.

##Significance

These activities will provide critical experience, data, and materials to support successful grant proposals to the American Cancer Society or National Cancer Instutute to study the reach, efficacy and overall robustness of "FLU-FIT" campaigns when disseminated and implemented in other Kaiser Permanente or HMO Cancer Research Network settings. This project will develop a system to use annual flu shot clinics as an opportunity for nurses to identify and offer annual CRC screening with FIT to eligible adults. The success of this project and its widespread application in other clinical settings could lead to greater access to CRC screening for millions of Americans, with improved cancer-related health outcomes for thousands who receive early diagnosis and treatment.

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