Problems with Fecal Immunochemical Testing in a Safety Net Healthcare System

Most colorectal cancer screening in the United States is offered in the opportunistic setting, i.e., by a physician recommendation during an office visit. Programmatic or organized screening, in which screening is offered systematically to all eligible patients in a healthcare system and adherence is monitored at the system level, is uncommon in the U.S.

In the current study, researchers assessed adherence to opportunistic screening in a U.S. safety net hospital system, usually by fecal immunochemical test (FIT). The population comprised over 18,000 patients, most of whom were non-Hispanic black (41%) or Hispanic (35%). Adherence was measured as a portion of time covered (PTC), such that patients were considered adherent if they had undergon…