FIT Kit Distribution Strategies for Colorectal Cancer Prevention

Recruiting at 1 trial location

Overseen By Jungyoon Kim, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Nebraska

Disqualifiers: Colorectal cancer, Adenomas, Inflammatory bowel, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

1200 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to identify the best methods for distributing home test kits for colorectal cancer screening among African Americans. Participants will receive a Fecal Immunochemical Test (FIT) kit either directly at a local DMV office in Omaha or with additional social media support. The researchers aim to determine which method encourages more people to return the kits and complete follow-up care if needed. This trial is suitable for African Americans aged 45-75 who live in Douglas County, NE, and are not up-to-date with their colorectal cancer screenings. As an unphased study, it offers a unique opportunity to contribute to improving health outcomes in the community.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on distributing and returning FIT kits for colorectal cancer screening.

What prior data suggests that the FIT kit distribution strategies are safe for colorectal cancer screening?

Research shows that the fecal immunochemical test (FIT) safely and painlessly checks for colorectal cancer. This test detects tiny amounts of blood in stool, which can indicate cancer or other health issues. The U.S. Preventive Services Task Force recommends the FIT for colorectal cancer screening, confirming its safety for most people.

Studies have shown that the FIT is noninvasive, requiring no internal procedures. It is also easy to use at home. Reports of major side effects from using the FIT are absent, enhancing its reputation as a well-tolerated cancer screening option.

Overall, the FIT is a trusted and widely accepted method for early detection of colorectal cancer, significantly improving treatment success. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to increase colorectal cancer screening rates through FIT kit distribution strategies. Unlike traditional methods that rely solely on doctor visits for distribution, this approach brings FIT kits directly to the community at convenient locations like the DMV. Additionally, one arm of the trial uses targeted social media advertising to reach African American adults aged 45-75, which could increase awareness and participation. By making screening more accessible and engaging, this trial could lead to higher participation rates and earlier detection of colorectal cancer.

What evidence suggests that this trial's FIT kit distribution strategies could be effective for colorectal cancer prevention?

Research shows that fecal immunochemical tests (FIT) effectively screen for colorectal cancer. Studies indicate that FIT can significantly reduce the risk of dying from this cancer by detecting it early. A large study found that using FIT led to a notable decrease in deaths from colorectal cancer. In this trial, participants will receive FIT kits through different distribution strategies. One group will receive mailed FIT kits, which has increased screening rates, especially among low-income and minority groups. Another group will receive FIT kits on-site, a practical and cost-effective way to boost participation in screening. Both mailed and on-site FIT testing effectively detect colorectal cancer early, potentially saving lives. ^{1 6 7 8 9}

Who Is on the Research Team?

Jungyoon Kim, PhD

Principal Investigator

University of Nebraska

Are You a Good Fit for This Trial?

This trial is for African Americans aged 45-75 in Douglas County, NE who haven't kept up with colorectal cancer screenings. They must be able to communicate in English and provide contact info. People with a personal or family history of colorectal cancer, adenomas, or inflammatory bowel disease cannot join.

Inclusion Criteria

I am between 45 and 75 years old.

Ability to speak, read, and write English

I am not current with my colorectal cancer screenings.

Exclusion Criteria

My family has a history of colorectal cancer.

I have had colorectal cancer in the past.

I have had precancerous polyps or inflammatory bowel disease.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

3-6 months

Intervention

Participants receive FIT kits at DMV locations, with one group also receiving targeted social media advertisements

2.5 months

1 visit (in-person at DMV), ongoing virtual engagement

Follow-up

Participants are monitored for FIT kit return rates and follow-up colonoscopy completion after positive results

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Mailed Fecal Immunochemical Test (FIT) Kit Distribution
• On-site Fecal Immunochemical Test (FIT) Kit Distribution

Trial Overview The study compares two ways of giving out FIT kits for colorectal cancer screening: handing them directly to people at DMV locations versus mailing them. It aims to see which method gets more people screened and is more cost-effective.

How Is the Trial Designed?

Group I: On-site Group Experimental Treatment 1 Intervention

The on-site distribution group will receive the Fecal Immunochemical Test (FIT) kits directly while visiting the Department of Motor Vehicles (DMV) location at 4606 N 56th St Suite 100, Omaha, NE 68104. Participants in the on-site group will be guided through the kit process by trained research staff present. They will be given instructions on collecting the stool sample and using the FIT kit properly. They will also be given a culturally tailored educational brochure, a prepaid return envelope, and receive reminder text messages and phone calls within 3 weeks of receipt of the FIT kit. Post-FIT navigation support will be provided for those with positive results or without a family doctor/insurance.

Group II: On-site Group With Social Media Advertising Active Control 1 Intervention

The onsite group with social media advertising participants will receive FIT kits directly at the Department of Motor Vehicles (DMV) location at 4606 N 56th St Suite 100, Omaha, NE 68104. Additionally, they will be exposed to targeted social media advertisements on Facebook, Instagram, and YouTube. These participants will encounter ads featuring video content with community member testimonials, emphasizing the importance of colorectal cancer screening for African Americans aged 45-75. The campaign will run from August 19 to October 29, 2024. Participants in this group will receive the FIT kits at the DMV along with detailed instructions on how to collect the stool sample and use the kit. They will also receive a culturally tailored educational brochure, prepaid return envelope, reminder text messages, and phone calls within three weeks of receipt of the FIT kit. Post-FIT navigation support will be provided for those with positive results or without a family doctor/insurance.

Mailed Fecal Immunochemical Test (FIT) Kit Distribution is already approved in United States, European Union, Canada, Japan, Brazil for the following indications:

Approved in United States as Fecal Immunochemical Test for:

• Colorectal Cancer Screening

Approved in European Union as Fecal Immunochemical Test for:

• Colorectal Cancer Screening

Approved in Canada as Fecal Immunochemical Test for:

• Colorectal Cancer Screening

Approved in Japan as Fecal Immunochemical Test for:

• Colorectal Cancer Screening

Approved in Brazil as Fecal Immunochemical Test for:

• Colorectal Cancer Screening

Who Is Running the Clinical Trial?

University of Nebraska

Lead Sponsor

Trials

563

Recruited

1,147,000+

Robert Wood Johnson Foundation

Collaborator

Trials

161

Recruited

697,000+

Published Research Related to This Trial

Fecal immunochemical testing (FIT) is an effective screening method for colorectal cancer, but an abnormal result requires follow-up colonoscopy, which not all patients complete.

A new risk prediction model was successfully redeveloped for a specific health center, identifying patients unlikely to follow up on abnormal FIT results, although the original model did not recalibrate well in a different setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The recalibration and redevelopment of a model to calculate patients' probability of completing a colonoscopy following an abnormal fecal test. Petrik, AF., Johnson, ES., Slaughter, M., et al.[2023]

The fecal immunochemical test (FIT) is a highly sensitive tool for colorectal cancer screening, outperforming older guaiac tests by detecting hemoglobin more effectively, which allows for screening with just one stool sample per cycle.

FIT's growing use in both individual and programmatic settings highlights its potential for improving colorectal cancer detection and monitoring, making it a valuable option for public health initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fecal Immunochemical Test: The World's Colorectal Cancer Screening Test. Robertson, DJ., Selby, K.[2021]

In a study of 56,980 average-risk individuals aged 50-74, 10.2% had an unsatisfactory fecal immunochemical test (FIT), primarily due to inadequate specimens and incomplete labeling.

Less than half (41%) of those with an unsatisfactory FIT completed a follow-up test within 15 months, indicating a need for improved patient education and support in screening programs to enhance colorectal cancer detection.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Unsatisfactory Fecal Immunochemical Tests for Colorectal Cancer Screening: Prevalence, Reasons, and Subsequent Testing. Liu, PH., Nair, RG., Skinner, CS., et al.[2023]

The use of postal distribution of fecal immunochemical test (FIT) kits significantly increased colorectal cancer screening participation rates from 24.5% to 42.6%, and further to 51.4% with follow-up telephone reminders, demonstrating the effectiveness of this intervention in underserved regions of Korea.

Factors such as low educational attainment and poor previous participation in screening programs were linked to lower response rates, highlighting the need for targeted outreach to improve participation among these groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increase in the Colorectal Cancer Screening Rate by a Round-Mailed Fecal Immunochemical Testing Kit and Associated Factors in Underserved Regions of Korea: A Community-Based Intervention Study. Hong, S., Shin, HY., Lee, B., et al.[2021]

Fecal immunochemical testing (FIT) outreach significantly increased screening completion rates (42.4%) compared to point-of-care (POC) strategies (24.0%), indicating that mailing FIT kits and following up with reminders is more effective in encouraging patients to get screened for colorectal cancer.

Although FIT outreach is more effective, it is also more expensive ($30.43 per patient) compared to POC distribution ($4.93 per patient), which may pose challenges for community health centers under current payment models.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outreach for Annual Colorectal Cancer Screening: A Budget Impact Analysis for Community Health Centers. Liss, DT., French, DD., Buchanan, DR., et al.[2016]

In a study of 323,349 health plan members aged 50 to 70, annual fecal immunochemical test (FIT) screening demonstrated high sensitivity for detecting colorectal cancer (CRC), identifying 80.4% of CRC cases diagnosed within a year, with the highest detection rate in the first round (84.5%).

Participation in annual FIT screening was strong, with 48.2% of invited patients participating in the first round and 75.3% to 86.1% continuing in subsequent rounds, indicating that programmatic FIT screening is both feasible and effective for population-level CRC screening.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fecal Immunochemical Test Program Performance Over 4 Rounds of Annual Screening: A Retrospective Cohort Study. Jensen, CD., Corley, DA., Quinn, VP., et al.[2022]

In a large-scale screening program involving over 1.9 million participants, the parallel use of fecal immunochemical test (FIT) and risk assessment (RA) achieved a sensitivity of 78% and a specificity of 78% for detecting colorectal cancer (CRC), indicating a balanced approach to screening.

The study found that while the combination of RA and FIT improved sensitivity for CRC detection compared to FIT alone, the overall effectiveness of FIT as a standalone initial screening test was limited, suggesting a need for optimization in risk assessment methods to enhance screening outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diagnostic accuracy of risk assessment and fecal immunochemical test in colorectal cancer screening: Results from a population-based program and meta-analysis. Wang, Z., Teng, J., Wu, W., et al.[2023]

Citations

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Mailed Fecal Immunochemical Test Outreach for Colorectal ... Mailed fecal immunochemical testing (FIT) ... Cost-effectiveness of one versus two sample faecal immunochemical testing for colorectal cancer screening.

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2821348

Fecal Immunochemical Test Screening and Colorectal ... This nested case-control study analyzed associations of fecal immunochemical test screenings with risk of death from colorectal cancer ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4676309/

Effectiveness of fecal immunochemical testing in reducing ... A significant reduction in colorectal cancer mortality resulting from fecal immunochemical testing is demonstrated by a large, population-based, nationwide ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S1542356521007539

Increased Colorectal Cancer Screening Sustained with ... Reports of mailed fecal immunochemical test (FIT) outreach effectiveness over time are minimal. We aimed to better evaluate a mailed FIT program with ...

5. acsjournals.onlinelibrary.wiley.com acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.35369

A pragmatic randomized trial of mailed fecal immunochemical ... A pragmatic randomized trial of mailed fecal immunochemical testing to increase colorectal cancer screening among low-income and minoritized populations.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8606361/

Effectiveness and Cost-effectiveness of Mailed FIT in a Safety ... Mailed fecal immunochemical testing (FIT) can increase colorectal cancer (CRC) screening rates, including for vulnerable patients, ...

7. cancercareontario.ca cancercareontario.ca/en/types-of-cancer/colorectal/screening/fit-instructions

Fecal Immunochemical Test (FIT) Instructions The fecal immunochemical test (FIT) is a safe and painless test that checks your stool (poop) for tiny amounts of blood, which can be caused by colorectal ...

8. labcorp.com labcorp.com/cancer/colorectal/patients

Colon Cancer Screening and Test Information A fecal immunochemical test, or FIT, is a noninvasive test you can complete in the comfort of your own home. Understand your risk factors and talk with your ...

9. ebccp.cancercontrol.cancer.gov ebccp.cancercontrol.cancer.gov/programDetails.do?programId=26900022

Fecal Immunochemical Test (FIT) and Colonoscopy Outreach Designed to increase colorectal cancer screening (CRC), this intervention has two components: (1) FIT outreach, which consists of a mailed letter, FIT test kit ...