S696 Get FIT to Fight CRC: A Quality Improvement Initiative to Enhance Colorectal Cancer Screening Rates Using FIT at HHS Clinic

Introduction: Despite the availability of practical screening tools, colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States. Our clinic serves more than 80% of uninsured, non-English-speaking, or immigrant-status patients. The barriers, including invasive procedures, cost, insurance coverage, and accessibility, hinder the widespread adoption of screening. Fecal Immunochemical Testing (FIT), a non-invasive and low-cost stool-based screening method, offers a promising solution for increasing CRC screening rates, particularly among patients who are unable or unwilling to undergo colonoscopy. This quality improvement (QI) project was initiated to increase CRC screening rates through the structured implementation of FIT testing in average-risk adult patients. Our objective was to address existing screening gaps using evidence-based strategies and guideline-driven implementation. Methods: The project was conducted at the HHS primary care clinic in Jefferson Abington Hospital, serving a diverse patient population. The target population consisted of average-risk adults aged 45 to 75 who were due for colorectal cancer (CRC) screening. The aim was to increase CRC screening by at least 15% over a 10-month period (June 2024–May 2025). Interventions for this project included all provider education, clinic staff training, EMR optimization, patient engagement, and follow-up phone calls to ensure adequate participation. Results: The baseline screening rate was 32.9%. After the intervention, it increased to 40.5% (a 23% relative increase). Fifty-seven percent of previously unscreened patients completed the test. Patient acceptance increased due to FIT’s simplicity, and provider engagement improved with integrated electronic medical record tools. This initiative demonstrated that FIT implementation can significantly enhance CRC screening in primary care and help bridge screening gaps for uninsured patients. Conclusion: Critical factors for success included workflow integration, patient-centered communication, and team-based care. Challenges included ensuring follow-up for positive FIT results and managing supply logistics. Nonetheless, the project offers a scalable, low-cost, patient-centered approach to preventive care that can be adopted broadly to address disparities in CRC outcomes.