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1
Mailed FIT outreach increases colorectal cancer screening participation, particularly among underserved populations, and can be delivered without an in-person visit.
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2
In a cluster-randomized trial across Southern California FQHCs, mailed FIT outreach sustained screening rates near 40% over 3 years.
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3
Screening coverage in intervention clinics exceeded control coverage by 11 percentage points in years 1 and 2, but by 3 points at year 3, a nonsignificant difference.
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4
Incomplete outreach in the final year and a possible postpandemic screening rebound in control clinics may explain the smaller year 3 difference, but their contributions are unknown.
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5
Effective FIT outreach depends on context, including organized eligibility registers, proactive invitations, health system infrastructure, and sufficient resources.
