Researchers from the UCLA Health Jonsson Comprehensive Cancer Center were awarded a $3 million grant from the National Institutes of Health to improve follow-up care for colorectal cancer screening in underserved populations.
Despite colorectal cancer being the second leading cause of cancer-related deaths in the United States, screenings for the disease remain underutilized, particularly in low-resource settings. The new study will focus on increasing follow-up care for underserved patients who receive abnormal results from stool-based fecal immunochemical tests (FIT). These tests are cost-effective and widely used, but timely follow-up colonoscopies are critical to detect cancer or remove pre-cancerous polyps.
To help ensure more people benefit from screening, Dr. Folasade May, an associate professor of medicine at the David Geffen School of Medicine at UCLA and associate director of the UCLA Kaiser Permanente Center for Health Equity, and Dr. Beth Glenn, professor of Health Policy and Management in the UCLA Fielding School of Public Health and associate director of the UCLA Kaiser Permanente Center for Health Equity, are leading a team of researchers in public health, health services, and health economics who will evaluate a multilevel health system intervention in one of the largest Federally Qualified Health Centers systems in the country, where only 18-30% of patients who receive abnormal FIT results complete the necessary colonoscopy follow-up.
The focus of intervention is on improving coordination between primary care clinics where the initial screening is done and specialty care clinics that perform the follow-up colonoscopies. Intervention components target patients, primary and specialty health care providers and aim to improve system-level processes to increase colonoscopy completion rates.
The study will assess the intervention's effectiveness, feasibility and cost, with the goal of finding scalable solutions for underserved populations. Findings could help improve colorectal cancer screening processes in other similar health settings, ultimately increasing survival and reducing mortality in vulnerable groups and overall.
“We know that timely screening follow-up is essential to reducing colorectal cancer risk, but too many patients—especially those in underserved communities—are slipping through the cracks,” said May. “This grant allows us to test a real-world solution to help bridge the gap between detection and diagnosis, ultimately saving lives.”
UCLA co-investigators include Dr. Roshan Bastani, director of Disparities and Community Engagement and co-director of Prevention and Control Research at the UCLA Health Jonsson Comprehensive Cancer Center and director of the UCLA Kaiser Permanente Center for Health Equity; Dr. Catherine Crespi, professor of Biostatistics in the UCLA Fielding School of Public Health; Dr. Srikanth Kadiyala, adjunct assistant professor in the UCLA Fielding School of Public Health; and Dr. Michael Ong, professor in residence of medicine and health policy and management at UCLA.
