Colorectal cancer (CRC) is the third most common cause of cancer deaths in the United States, with an estimated 149 500 new cases in 2021. Approximately half of the 53 200 deaths from CRC this year could be prevented if appropriate screening was widely implemented. CRC incidence and mortality rates have declined over the past 2 decades due, in part, to greater participation in screening. For people at average risk for CRC—those who have no risk factors other than age—test options include annual fecal immunochemical tests (FITs) or colonoscopy every 10 years. The effectiveness of any screening test depends on high rates of adherence and quality, but up to 50% of people who receive a recommendation for screening colonoscopy do not complete this test. Although several test options are available, providers almost universally recommend colonoscopy, which has contributed to low overall screening rates because many are unwilling to undergo a colonoscopy and then forego screening altogether. Interventions that improve patients’ knowledge about CRC screening, enhance access, improve skills needed to complete CRC screening, reduce barriers, and offer test options other than colonoscopy will lead to more people being screened. Both patient navigation (PN) and computer-tailored interventions have been shown to increase CRC screening rates; however, no studies have examined their comparative effectiveness or the effects of combining them.
