Gastroenterology · General Practice · 1 h ago
VA Mailed FIT Program Reaches 89.5% of Eligible Facilities
A Veterans Health Administration implementation study describes national rollout of mailed fecal immunochemical testing (FIT) for colorectal cancer screening. From December 2022 through September 2025, 40.2% of 643,933 ordered tests were returned; greater program adoption was associated with more Veterans being up to date with screening.
- Mailed FIT reached 89.5% of eligible VA facilities.
- Only 40.2% of ordered tests were returned.
- Colonoscopy followed 54.4% of abnormal FIT results.
- Higher adoption correlated with screening being up to date.
The Veterans Health Administration (VA) developed a national mailed FIT program in response to screening disruptions during the COVID-19 pandemic. It adapted processes from a CDC-sponsored implementation guide, conducted regional pilots, established a national implementation team, and provided facilities with training and tools. This report describes implementation and initial outcomes across VA facilities; it is not a randomized comparison of screening strategies.
Mailed FIT had been implemented at 89.5% of eligible facilities. From December 1, 2022, to September 30, 2025, 643,933 tests were ordered and 40.2% were returned. Of returned tests, 89.1% were testable. Among 230,427 results, 7.4% were abnormal, and colonoscopy was completed in 54.4%. In 5,846 VA colonoscopies, adenomas were found in 68.0% and adenocarcinoma in 2.3%. Greater program adoption correlated with a higher proportion of Veterans up to date with screening (r=0.65, p=0.003).
These findings support the feasibility of large-scale mailed FIT outreach, while showing gaps in test return and follow-up colonoscopy. The reported association does not establish that program adoption caused improved screening status, and the findings reflect the VA system; implementation and follow-up may differ in other settings.
In practice
For clinicians involved in colorectal cancer screening, this VA report indicates that centralized mailed FIT outreach can be implemented across most eligible facilities, but return and follow-up remain important gaps: 40.2% of ordered tests were returned, and colonoscopy was completed after 54.4% of abnormal results. The association between broader adoption and screening status does not prove causation. These findings come from the VA system and do not establish that the same uptake or follow-up rates would occur in other health systems.
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The American Journal of Gastroenterology: Implementation of Programmatic Mailed Fecal Immunochemical Testing for Colorectal Cancer Screening in the Veterans Health Administration ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.