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According to the American Cancer Society, colorectal cancers are diagnosed in 1 in 22 men and 1 in 24 women in their lifetime. Despite the wide range of effective CRC screening options available in the US, the Hudson Headwaters Health Network (HHHN) has seen little improvement in its CRC screening rates of approximately 60-63% in recent years. This places HHHN, an FQHC in Upstate New York, well below the National Colorectal Cancer Round Table 2018 goal of 80% screening in eligible, average-risk adults. This quality improvement project sought to improve HHHN’s CRC screening rates through a new FITKit direct-mailing initiative. A literature search was conducted, informing the design of a pilot mailing initiative based on recent studies of direct-mailing FITKit outreach in comparable FQHC’s and safety net institutions. In mid-January, 2019, FITKits with return address labels and postage were mailed to 362 HHHN patients’ homes. The cohort represented a population that was age 50-75, currently failing the CRC screening measure, had not seen a PCP in the last calendar year, had BMI ≥ 30, and had 0-5 comorbidities per a network-wide EMR data search in December, 2018. These mailings were preceded by an introductory email and included a second introductory letter along with the network’s usual ‘FITKit Facts and FAQ’s’ sheet. Mailings were followed by two or more automated phone reminders to complete the screening. Only one month after mailings were released, the network received 26 completed FITKits for processing, representing a 7.14% early return rate for the initiative.

Clinical Site

Hudson Headwaters Health Network, Glens Falls, NY


New York, Colorectal Cancer, Cancer Screening, FITKit, FQHC, Hudson Headwaters Health Network, Mailing, Quality Improvement

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Colorectal Cancer Screening Quality Improvement: A FITKit Mailing Initiative

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