Improving colorectal cancer screening rates in veterans: A quality improvement initiative.

Abstract

e23217 Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Routine screening significantly lowers CRC incidence and mortality. The US Preventive Services Task Force (USPSTF) recommends screening for individuals aged 45–75, with personalized recommendations for those aged 76–85. Screening options include annual guaiac fecal occult blood testing (FOBT), annual fecal immunochemical testing (FIT), multitarget stool DNA-FIT every 1–3 years, sigmoidoscopy every 5–10 years with or without FIT, computed tomographic colonography every 5 years, or colonoscopy every 10 years. Methods: This Quality Improvement Project evaluated CRC screening in veterans aged 45–75 at a Veterans Affairs clinic. We reviewed charts to identify patients eligible but not screened. These patients were mailed a pamphlet explaining the importance of screening and detailing available methods, including their risks and benefits. Screening discussions were conducted via telephone and during patients’ annual follow-up visits, with appropriate testing ordered for those who consented. After 12 months, charts were re-assessed to compare screening rates before and after intervention. Exclusion criteria included patients younger than 45 and those newly established at the clinic during the study period. Results: Among 216 eligible patients, 46 (21%) had missed age-appropriate screenings. Following intervention, 28 patients underwent screening colonoscopy, 8 completed FIT, and 10 declined intervention. The pre-intervention screening rate of 79% increased to 96% post-intervention, demonstrating a marked improvement in adherence. Conclusions: Our findings highlight the potential of targeted outreach and integrating screening discussions into routine care to address gaps and improve CRC detection rates in veteran populations. Increased awareness and adherence to screening guidelines can significantly reduce the burden of CRC-related morbidity and mortality. Colorectal cancer screening outcomes. Category Number of Patients (n) Percentage (%) Total patients eligible for screening 216 100% Patients with missed screenings (pre-intervention) 46 21% Intervention Outcomes  Screening colonoscopy completed 28 61% of missed  FIT testing completed 8 17% of missed  Refused screening 10 22% of missed Screening Rates  Screening rate pre-intervention - 79%  Screening rate post-intervention - 96% "Missed screenings" refers to patients who had not completed any age-appropriate colorectal cancer screening at the initial chart review. Percentages for intervention outcomes are calculated based on patients with missed screenings (n=46), while pre- and post-intervention screening rates are based on the total eligible population (n=216). FIT: Fecal immunochemical test, a non-invasive stool-based screening method.