Increasing Veteran access to colon cancer screenings

Colon cancer is the second leading cause of cancer death in America. Dr. Jason Dominitz, executive director of VA’s National Gastroenterology and Hepatology Program, knows that it doesn’t need to be. According to Dominitz, the majority of colon cancers can be cured if detected early.

Most colon cancer screenings in VA are done with either colonoscopy or a fecal immunochemical test (FIT). FIT is a non-invasive test where Veterans collect a tiny stool sample in the comfort of their own home and mail it back to VA for analysis. However, hundreds of thousands of Veterans are unscreened or behind on screenings, and the COVID-19 pandemic only increased the problem.

“Routine colonoscopies came to halt in March 2020 and have not yet fully recovered,” said Dominitz. “We also can’t hand out FIT kits during telemedicine visits,” he explained, highlighting one of the major issues facing Veterans and their physicians.

Fortunately, there was a solution: Mailed FIT kits for Veterans to use in their homes.

An innovative approach to colon cancer screenings

Dominitz trained at Durham VA in health services research and now works at Seattle VA. He was exposed to the idea of Mailed FIT after Kaiser Permanente successfully rolled out a similar program.

He partnered with staff from VISN 21 and other VA program offices, such as Primary Care, Laboratory Medicine and the National Center for Health Promotion and Disease Prevention. This approach, while not replacing current screening efforts, makes screening easy while simultaneously increasing colonoscopy access for Veterans with the highest risk for colon cancer.

“Mailed FIT separates colon cancer screening from the in-person visit and meets the needs for Veterans who don’t come in on a regular or frequent basis,” Dominitz said. “It also allows us to transition from an opportunistic approach to screening… where we have to wait for the Veteran to come in… to an organized approach, ensuring more Veterans have access.”

Increasing access on a national scale

With help from VHA Diffusion of Excellence and the VHA Shark Tank Competition, Mailed FIT is now ramping up to serve Veterans across the nation.

Shark Tank identifies frontline employee innovations that promote positive outcomes and improved experiences for Veterans, employees, caregivers and VHA community.

“It’s not been an easy process and we couldn’t do it without a wonderful team of dedicated professionals, including Chris Moore,” said Dominitz. Moore is a health systems specialist from VISN 21. “The fact that there is the ability within VA to take care of a problem on a national, enterprise-level is relatively unique in the US health care system.”

Want to learn more about Mailed FIT and colorectal cancer screening at VA? You can explore their webpage on the Diffusion Marketplace to learn more about the techniques and spread of this rapidly growing innovation.

Innovation Heroes is a recurring series from the VHA Innovation Ecosystem, focusing on VA employees who are driving innovation forward and improving the lives of Veterans and fellow VA employees.

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