Improving Colorectal Cancer Screening through Multifaceted Interventions

Research at an urban primary care clinic in New York City has led to significant improvements in colorectal cancer (CRC) screening rates among patients who visited the clinic in the first half of 2023. A staggering 62% of patients were found to have completed CRC screening, highlighting the importance of early detection and prevention. However, barriers to higher-than-national-average CRC screening rates, including limited awareness and understanding among providers and patients, were identified. To address these gaps, a series of targeted interventions were implemented, including provider education sessions, patient-facing educational materials, and electronic medical record portal outreach.

Key Takeaways:

• The clinic's prior analysis revealed a CRC screening completion rate of 62% in patients who had visited the clinic in the first half of 2023.
• Identified barriers to higher-than-national-average CRC screening rates included limited awareness and understanding among both providers and patients regarding CRC screening options and processes, particularly Cologuard.
• A series of targeted interventions aimed at increasing Cologuard utilisation included provider education sessions, patient-facing educational materials, and electronic medical record portal outreach.
• The primary outcome was Cologuard completion rate among CRC-screening eligible patients, which improved from 7.38% to 10.00% after the interventions.
• Median order rates rose from 14.59% to 18.71%, and overall CRC screening rates increased from 68.6% to 72.2% after the interventions.
• Direct patient messaging had the most immediate impact, with 7.2% responses by recipients, resulting in 16 screenings and a transient peak of 20.71% in monthly Cologuard completion.
• The project demonstrates that practical, multifaceted, low-cost strategies can significantly improve Cologuard usage, ultimately leading to an increase in CRC screening completion rates.
• Sustained reinforcement and improvement in kit return will be a key to future improvements in CRC screening rates.

Statistics:

• 2171 CRC-screening eligible patients visited during the intervention period.
• 399 Cologuard orders were placed, with 235 completed kits returned.
• Cologuard completion rates improved from a median of 7.38% to 10.00%.
• Median order rates rose from 14.59% to 18.71%.
• Overall CRC screening rates increased from 68.6% to 72.2% after the interventions.
• 7.2% of recipients responded to direct patient messaging, resulting in 16 screenings.

Sources:

• NewsRx. Findings from Mount Sinai Beth Israel Provide New Insights into Colon Cancer (Improving colorectal cancer screening through Cologuard education: a quality improvement initiative in an urban primary care clinic). Cancer Weekly. October 21, 2025; p 165.
• Improving colorectal cancer screening through Cologuard education: a quality improvement initiative in an urban primary care clinic. BMJ Open Quality, 2025;14(4).