P3206 - Staying FIT: Increasing Colorectal Cancer Screening Rates in Average Risk Veterans Aged 45-49 in Southeast Louisiana

Duncan Pearce, MD¹, Ryan Burden, MD², Jaya Bommireddipally, MD³, Marla Stewart, RN⁴, Anthony Marsh, MD⁴, Leela Nayak, MD⁴, Tanya Payton, ⁴, William Kirsch, ⁴, Caitlin Martin-Klinger, MD⁴, Albert Jang, MD^1
1Tulane Medical Center, New Orleans, LA; ²Tulane University School of Medicine, New Orleans, LA; ³Tulane University, New Orleans, LA; ⁴VA Southeast Louisiana Healthcare, New Orleans, LA

Introduction: Louisiana has the fifth highest colorectal cancer (CRC) death rate in the United States. In December 2022, the Southeast Louisiana Veterans Health Care System (SLVHCS) had over 13,000 open CRC screening reminders among 29,000 veterans eligible for screening. Of the 1,700 average-risk veterans aged 45-49, over 80% were not up to date on CRC screening. Fecal Immunochemical Testing (FIT) is an efficient and cost-effective way to screen for CRC in many average-risk patients. The overarching goal of this project was to increase CRC screening in veterans aged 45-49 through the increased distribution of FIT kits and decrease the percentage of open CRC reminders in this age group.

Methods: A process map was created to identify issues that may be contributing to low rates of CRC screening at SLVHCS. The baseline process for sending FIT kits to veterans did not include those aged 45-49 due to the use of an outdated informatics tool. In March 2023, the system for FIT kit distribution was updated to include average-risk veterans aged 45-49 due for CRC screening. Data regarding open CRC screening reminders and the number of FIT kits distributed amongst the clinics were collected weekly from December 2022 through May 2023.

Results: Including veterans aged 45-49 in the FIT distribution process led to a rapid increase in the number of FIT kits distributed each week to this age group, with the pre-intervention average of 13 kits/week (Dec. 2022-Feb. 2023) increasing to an average of 43 kits/week post-intervention (March 2023-May 2023). The percentage of open CRC reminders for average-risk veterans aged 45-49 also decreased during the intervention period from 82.9% in early March down to 73.8% in late May 2023.

Discussion: The prior FIT distribution system relied on an outdated informatics tool used by the FIT coordinator, which largely excluded veterans aged 45-49. A multidisciplinary team of physicians, nurses, Lean practitioners, and informatics staff worked to develop an updated process that included this at-risk group. Through this process modification, we demonstrated a sustained increase in FIT kit distribution to veterans aged 45-49, leading to a decrease in the number of open CRC reminders. Future interventions will seek to further increase the efficiency of FIT distribution by implementing an automated mailing and reminder system for veterans to return their FIT kits.



Disclosures:


Duncan Pearce, MD¹, Ryan Burden, MD², Jaya Bommireddipally, MD³, Marla Stewart, RN⁴, Anthony Marsh, MD⁴, Leela Nayak, MD⁴, Tanya Payton, ⁴, William Kirsch, ⁴, Caitlin Martin-Klinger, MD⁴, Albert Jang, MD¹. P3206 - Staying FIT: Increasing Colorectal Cancer Screening Rates in Average Risk Veterans Aged 45-49 in Southeast Louisiana, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.