Colonoscopy Completion Up 69% With Patient Navigation Program After FIT: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On April 18, 2025, we reported on a study published in Annals of Internal Medicine that examined whether patient navigation delivered to people with an abnormal fecal immunochemical test (FIT) result increased follow-up colonoscopy completion at 1 year.

The study

The PRECISE (Predicting and Addressing Colonoscopy non-Adherence in Community Settings) study enrolled 985 adults aged 50 to 75 years who had received an abnormal FIT result in the previous month at Sea Mar Community Health Centers, a FQHC operating 32 clinics in western Washington. The final cohort for the primary analysis comprised 967 people who were randomly assigned to the patient navigation group (479) or to usual care (488). Mean age of the cohort was 61 years and 46% were women.

Individuals in the navigation group participated in a 6-topic telephone-based program designed to identify and offer solutions to common barriers to follow-up, as well as to provide education on the procedure and interpreting results. All navigators were fluent in English and Spanish, authors noted, as 18% of participants indicated a preference for the latter. Navigators made up to 6 attempts for each scheduled call.

The findings

The researcher's modified intention-to-treat analysis found that approximately half (55.1%; 95% CI, 50.3% to 59.7%) of the intervention group and 42.1% (95% CI, 37.5% to 46.8%) of the usual care group had a colonoscopy procedure within 12 months. Results showed that navigation program participants were 69% more likely to undergo colonoscopy than those who experienced usual care (adjusted OR 1.69; 95% CI, 1.3-2.19).

Authors' comments

"Patient navigation is a recommended practice of the Guide to Community Preventive Services; little is known about whether it improves colonoscopy completion for adults who have received an abnormal stool test result...These findings support the effectiveness of patient navigation for follow-up colonoscopy completion."

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