{"doi":"10.1002/cncr.35369","title":"A pragmatic randomized trial of mailed fecal immunochemical testing to increase colorectal cancer screening among low‐income and minoritized populations","abstract":"BACKGROUND: Colorectal cancer (CRC) screening is underused, particularly among low-income and minoritized populations, for whom the coronavirus disease 2019 (COVID-19) pandemic has challenged progress in achieving equity. METHODS: A hub-and-spoke model was used. The hub was a nonacademic organization and the spokes were three community health center (CHC) systems overseeing numerous clinic sites. Via a cluster-randomized trial design, nine clinic sites were randomized to intervention and 16 clinic sites were randomized to usual care. Patient-level interventions included invitation letters, mailed fecal immunochemical tests (FITs), and call/text-based reminders. Year 1 intervention impact, which took place during the COVID-19 pandemic, was assessed as the proportion completing screening among individuals not up to date at baseline, which compared intervention and nonintervention clinics accounting for intraclinic cluster variation; confidence intervals (CIs) around differences not including 0 were interpreted as statistically significant. RESULTS: Among 26,736 patients who met eligibility criteria, approximately 58% were female, 55% were Hispanic individuals, and 44% were Spanish speaking. The proportion completing screening was 11.5 percentage points (ppts) (95% CI, 6.1-16.9 ppts) higher in intervention versus usual care clinics. Variation in differences between intervention and usual care clinics was observed by sex (12.6 ppts [95% CI, 7.2-18.0 ppts] for females; 8.8 ppts [95% CI, 4.7-13.9 ppts] for males) and by racial and ethnic group (13.8 ppts [95% CI, 7.0-20.6 ppts] for Hispanic individuals; 13.0 ppts [95% CI, 3.6-22.4 ppts] for Asian individuals; 11.3 ppts [95% CI, 5.8-16.8 ppts] for non-Hispanic White individuals; 6.1 ppts [95% CI, 0.8-10.4 ppts] for Black individuals). CONCLUSIONS: A regional mailed FIT intervention was effective for increasing CRC screening rates across CHC systems serving diverse, low-income populations.","journal":"Cancer","year":2024,"id":471107,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9489,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":453304,"name":"Scott C. Roesch","orcid":"0000-0001-6574-1916","position":1,"is_corresponding":false},{"id":1306052,"name":"Valesca Largaespada","orcid":null,"position":2,"is_corresponding":false},{"id":270728,"name":"Sheila F. Castañeda","orcid":"0000-0002-1975-0544","position":3,"is_corresponding":false},{"id":322433,"name":"Jesse Nodora","orcid":"0000-0001-6756-4423","position":4,"is_corresponding":false},{"id":322435,"name":"Borsika A. Rabin","orcid":"0000-0001-9837-7866","position":5,"is_corresponding":false},{"id":1306053,"name":"Jennifer Covin","orcid":null,"position":6,"is_corresponding":false},{"id":1273818,"name":"Kristine Ortwine","orcid":null,"position":7,"is_corresponding":false},{"id":1306054,"name":"Yesenia Preciado‐Hidalgo","orcid":null,"position":8,"is_corresponding":false},{"id":324464,"name":"Nicole Howard","orcid":null,"position":9,"is_corresponding":false},{"id":324467,"name":"James Schultz","orcid":null,"position":10,"is_corresponding":false},{"id":1306055,"name":"Nannette Stamm","orcid":null,"position":11,"is_corresponding":false},{"id":625947,"name":"Daniel Ramirez","orcid":"0009-0002-0805-1171","position":12,"is_corresponding":false},{"id":420904,"name":"Michael T. Halpern","orcid":"0000-0001-8514-6313","position":13,"is_corresponding":false},{"id":951239,"name":"Samir Gupta","orcid":"0000-0003-2656-3912","position":14,"is_corresponding":false},{"id":104596,"name":"Marı́a Elena Martı́nez","orcid":"0000-0002-6728-1834","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T02:05:44.736405Z","pmid":"38795024","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}