Original Investigation

Population Health Colorectal Cancer Screening Strategies in Adults Aged 45 to 49 Years

JAMA 10.1001/jama.2025.12049

August 04, 2025 at 11:00 AM EDT

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What is the most effective population health strategy to promote colorectal cancer screening among average-risk adults aged 45 to 49 years?In a randomized clinical trial of 20 509 participants, the 3 strategies requiring active choice through the electronic patient portal were significantly less effective than default unsolicited mailed fecal immunochemical test (FIT) outreach: 16.4%, 14.5%, and 17.4% vs 26.2%.Default unsolicited mailed FIT outreach was the most effective population health screening strategy for adults aged 45 to 49 years. Overall screening rates were low, underscoring the need for more effective strategies to engage this age group.

Corresponding Author: Folasade P. May, MD, PhD, MPhil, University of California, Los Angeles, 650 Charles Young Dr S, Room A2-125 CHS, Los Angeles, CA 90095-6900 (fmay@mednet.ucla.edu).

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