Equity Evaluation of an Intervention to Increase Colorectal Cancer Screening at Federally Qualified Health Centers.

Abstract (English)

Racially and ethnically minoritized patients are underscreened for colorectal cancer (CRC), resulting in racial/ethnic disparities. This secondary analysis of a pragmatic patient-randomized clinical trial compared effects of a CRC intervention across race/ethnicity. The multicomponent intervention included a mailed fecal immunochemical test (FIT) for patients in Federally Qualified Health Centers due for screening, plus patient navigation for positive FITs. Among 3,734 patients, 9.7% identified as Hispanic, 29.0% as non-Hispanic Black, and 61.3% as non-Hispanic White, similar across intervention and control arms (<i>P</i> = .73). The adjusted risk difference (RD) for CRC screening uptake between arms was 18.3% (95% CI, 15.6%-20.9%). In stratified analysis, adjusted RDs were 16.7% (95% CI, 7.5%-25.9%) for Hispanic patients, 13.9% (95% CI, 8.6%-19.0%) for non-Hispanic Black patients, and 20.7% (95% CI, 17.2%-24.1%) for non-Hispanic White patients, which did not differ significantly (interaction <i>P</i> = .79). Because the intervention effect did not differ by race/ethnicity, broad implementation among minoritized populations could improve CRC screening disparities.