At a randomized clinical trial presented at the American College of Gastroenterology 2026 Annual Scientific Meeting in Nashville, Tennessee, researchers evaluated a multilevel colorectal cancer screening intervention across multiple federally qualified health care centers in New York City, HCPLive reported.
Clinical Trial Results for Adults Aged 45 to 49 Years
The intervention successfully boosted screening rates across two distinct age demographics, offering new data for a newly eligible patient cohort. Among adults aged 45 to 49 years, 31.9% of the intervention group completed screening compared to 20.1% in the usual care group, yielding a statistically significant difference with a P value of .02. For the older cohort aged 50 to 75 years, completion rates reached 36.9% for the intervention arm versus 24.3% for usual care.
Multivariable analysis identified specific predictors associated with screening completion. Older age demonstrated an odds ratio of 1.014 with a 95% confidence interval ranging from 1.002 to 1.027. Spanish-speaking status also correlated with higher completion, showing an odds ratio of 1.43 and a 95% confidence interval of 1.07 to 1.91. Conversely, unemployment presented a lower completion rate, registering an odds ratio of 0.79 with a 95% confidence interval from 0.64 to 0.94.
Study protocol utilizes structured steps to eliminate testing friction
The study protocol utilized a structured sequence of evidence-based steps designed to eliminate friction in the testing process. Patients initially received a personalized notification letter stating they were overdue for screening and warning of upcoming materials. Two weeks later, participants received educational resources along with a prepaid, preaddressed fecal immunochemical test kit to complete at home and return via mail.
Nonresponders subsequently received a sequence of three reminder phone calls or text messages. A final notification letter informed patients that their screening would be redirected to their primary care clinician if they did not respond. Ten patients returned abnormal stool tests during the trial, and all ten completed a follow-up colonoscopy. Both patients and clinicians reported that the intervention steps were acceptable.
Analysis of Younger Adult Gains and Socioeconomic Factors
Aasma Shaukat noted that the 11- to 12-percentage-point gain among younger adults aged 45 to 49 years is particularly encouraging due to limited existing data in this newly eligible group. Shaukat pointed out that unemployment remained tied to lower completion rates regardless of insurance status or neighborhood income. According to Shaukat, unemployment likely introduces additional social burdens such as competing priorities or reduced self-efficacy, prompting her research team to investigate the correlation further.
Shaukat described the intervention framework as scalable across health systems and stated her team’s willingness to share materials with other providers. She stressed the necessity of tailoring outreach efforts using language-congruent materials and maintaining sustainability through dedicated resources like trained navigators. Despite the overall gains, absolute screening rates stayed low, highlighting persistent systemic disparities that require health systems to actively engage unscreened and under-screened populations.
Commonly Asked Questions About the New York City Trial
What specific screening method did the trial distribute to patients at home?
The trial mailed a prepaid, preaddressed fecal immunochemical test kit for participants to complete at home and return through the mail.
How many reminder attempts did nonresponders receive before referral to a clinician?
Nonresponders received a series of three reminder phone calls or text messages before a final letter notified them that their screening was referred back to their primary care clinician.
What disclosures did study author Aasma Shaukat report?
Shaukat reported relevant disclosures with Freenome, Geneoscopy, and UniversalDx.
When and where was the clinical trial data presented?
The findings were presented at the American College of Gastroenterology 2026 Annual Scientific Meeting held from October 9 to 14, 2026, in Nashville, Tennessee, under ClinicalTrials.gov identifier NCT06269744.
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