Document Type

Article

Publication Title

BMJ open quality

Abstract

BACKGROUND: The overall rates of colorectal cancer (CRC) in the US population have been declining steadily over the past 30 years, in large part due to timely cancer screenings. Despite the emergence of new screening modalities, a large portion of the population has not completed CRC screening in accordance with guidelines. Adequate and timely screening can prevent or detect CRC in earlier stages. Various factors have been identified that influence screening completion. Lower screening rates have been associated with the underserved population, especially in the immigrant community and patients with inadequate access to healthcare. In the USA, primary care clinics associated with internal and family medicine residency programmes often serve as catch-net clinics for the community, serving to provide care to those with a higher burden of social determinants of health.

OBJECTIVE: We aimed to increase the rates of CRC screening in a primary care clinic associated with the internal medicine residency programme of a large healthcare system. In October 2021, the clinic had a CRC screening rate of 55.40%.

METHODS: This prospective quality improvement study was implemented from July 2022 to January 2025 at the resident-run clinic. Data on CRC screening completion were analysed monthly.

INTERVENTIONS: Six Plan-Do-Study-Act cycles were implemented over the course of the project. These interventions were developed from results of root-cause analyses as well as feedback from patients and providers.

RESULTS: CRC screening rates rose from 55.40% to 65.79% over the period of interest with the implementation of sequential targeted interventions.

CONCLUSIONS: Underserved patients are at higher risk of CRC screening incompletion. Multifaceted interventions and multidisciplinary collaboration are essential for increasing CRC screening in this vulnerable population.

DOI

10.1136/bmjoq-2025-003604

Publication Date

12-10-2025

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