ArticleBMJ open quality2026
Patient-centred approach to improve colorectal cancer screening (CRC) in resource-limited communities.
Article in BMJ open quality, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe aim of this quality improvement initiative was to increase colorectal cancer (CRC) screening rates from 17.75% and 28.45% to 40% in patients aged 45-49 years and 50-75 years, respectively, at a resource-limited primary care clinic within 1 year. We identified a major gap in CRC screening in both age groups (45-49 and 50-75 years).
methodsWe implemented multifaceted, patient-centred interventions in a community clinic serving a diverse population. The intervention incorporated the use of stool-based testing (faecal immunochemical test and multi-targeted stool DNA test), colonoscopy referrals, patient navigation, multilingual education, electronic health record alerts and a real-time tracking dashboard. The primary outcome measure was CRC screening completion rates. Colonoscopy and stool test completion rates were the process measures.
resultsIn 45-49 years, we observed a sustainable, steady increase in CRC screening rates from 17.75% (n=400) to 41.25% during the study period and 59.50% 6 months poststudy, with a median rate of 52.38% in a run chart and a mean of 37.00% in the statistical process control (SPC) chart. In 50-75 years, we observed a sustainable increase in CRC screening rate from 28.45% (n=2879) to 46.16% during the study period and to 61.06% 6 months poststudy, with a median rate of 55.47% in a run chart and mean of 43.00% in a SPC chart. In 45-49 years, colonoscopy completion rates increased from the baseline rate of 25.93% (n=108) to 37.04% during the study period and to 43.52% 6 months poststudy. In 50-75 years, colonoscopy completion rates increased from the baseline rate of 74.01% (n=654) to 92.05% during the study period and to 97.55% 6 months poststudy.
conclusionsWe exceeded our goals to increase CRC screening in both age groups. Patient-centred care and system-integrated interventions may substantially increase CRC screening among underserved individuals.
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