ArticleDigestive diseases and sciences2021
Patient Navigation After Positive Fecal Immunochemical Test Results Increases Diagnostic Colonoscopy and Highlights Multilevel Barriers to Follow-Up.
Article in Digestive diseases and sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Scale-up evaluation results of a multi-level approach using mailed immunochemical test (FIT) and patient navigation to increase colorectal cancer screening rates in rural clinic settings.BMC primary care · 2026Trial
- Evaluating the Reach of a Patient Navigation Program for Follow-up Colonoscopy in a Large Federally Qualified Health Center.Cancer prevention research (Philadelphia, Pa.) · 2024Trial
- Prevalence, determinants, and barriers to follow-up colonoscopy after a positive fecal immunochemical test in Qaemshahr, Iran: A population-based cross-sectional study from 2022 to 2023.Preventive medicine reports · 2026Article
- From Detection to Delay: Real-World Gaps in Post-CologuardJournal of gastrointestinal cancer · 2025Article
- Comparing the effectiveness of implementation strategies to improve liver and colon cancer screening for Veterans: protocol for a large cluster-randomized implementation study.Implementation science : IS · 2025Article
- Approaches to address common barriers to colorectal cancer screening in rural communities of the CDC's colorectal cancer control program.Preventive oncology & epidemiology · 2025Article
- Patterns of Care Following a Positive Fecal Blood Test for Colorectal Cancer: A Mixed Methods Study.Journal of general internal medicine · 2024Article
- Optimizing tracking and completion of follow-up colonoscopy after abnormal stool tests at health systems participating in the Centers for Disease Control and Prevention's Colorectal Cancer Control Program.Cancer causes & control : CCC · 2024Article
- Acceptability of Patient Navigation to Promote Follow-up Colonoscopy.American journal of health behavior · 2024Article
- Provision of colonoscopy in rural settings: A qualitative assessment of provider context, barriers, facilitators, and capacity.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- Unsatisfactory Fecal Immunochemical Tests for Colorectal Cancer Screening: Prevalence, Reasons, and Subsequent Testing.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Methods for scaling up an outreach intervention to increase colorectal cancer screening rates in rural areas.Implementation science communications · 2024Article
- Impact of Eliminating Cost-Sharing by Medicare Beneficiaries for Follow-Up Colonoscopy After a Positive Stool-based Colorectal Cancer Screening Test.Cancer research communications · 2023Article
- Paying Attention to Miss(ed) FITs.Digestive diseases and sciences · 2021Article
- Centralized colorectal cancer screening outreach and patient navigation for vulnerable populations in North Carolina: study protocol for the SCORE randomized controlled trial.Implementation science communications · 2021Article
- Perceptions on Barriers and Facilitators to Colonoscopy Completion After Abnormal Fecal Immunochemical Test Results in a Safety Net System.JAMA network open · 2021Article
- Abnormal Colorectal Cancer Test Follow-Up: A Quality Improvement Initiative at a Federally Qualified Health Center.Journal of primary care & community healthArticle
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe fecal immunochemical test (FIT) is a common colorectal cancer screening modality in the USA but often is not followed by diagnostic colonoscopy.
aimsWe investigated the efficacy of patient navigation to increase diagnostic colonoscopy after positive FIT results and determined persistent barriers to follow-up despite navigation in a large, academic healthcare system.
methodsThe study cohort included all health system outpatients with an assigned primary care provider, a positive FIT result between 12/01/2016 and 06/01/2019, and no documentation of colonoscopy after positive FIT. Two non-clinical patient navigators engaged patients and providers to encourage follow-up, offer solutions to barriers, and assist with colonoscopy scheduling. The primary intervention endpoint was completion of colonoscopy within 6 months of navigation. We documented reasons for persistent barriers to colonoscopy despite navigation and determined predictors of successful follow-up after navigation.
resultsThere were 119 patients who received intervention. Of these, 37 (31.1%) patients completed colonoscopy at 6 months. In 41/119 (34.5%) cases, the PCP did not recommend colonoscopy, most commonly due to a normal colonoscopy prior to the positive FIT (19, 46.3%). There were 41/119 patients (34.5%) that declined colonoscopy despite the patient navigator and the PCP order. Male sex and younger age were significant predictors of follow-up (aOR = 2.91, 95%CI, 1.18-7.13; aOR = 0.92, 95%CI, 0.87-0.99).
conclusionsAfter implementation of patient navigation, diagnostic colonoscopy was completed for 31.1% of patients with a positive FIT result. However, navigation also highlighted persistent multilevel barriers to follow-up. Future work will develop targeted solutions for these barriers to further increase FIT follow-up rates in our health system.
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