Ma Somsouk, MD, MS
Ma Somsouk, MD, MS, is a Professor in Residence in the Division of Gastroenterology, the Dean Craig Endowed Chair in Gastrointestinal Medicine, a member of the Helen Diller Family Comprehensive Cancer Center, a core faculty in the Center for Vulnerable Populations, and a colorectal cancer task force co-lead for the SF CAN initiative (a community partnership to reduce the cancer burden in the City and County of San Francisco). His research program has examined the cost and effectiveness of an organized outreach initiative using fecal immunochemical test kits for colorectal cancer screening, working with the population health and quality unit within the San Francisco Health Network to use electronic medical records and claims data to implement and continuously improve cancer screening interventions. Currently, he is a co-principal investigator on a research study funded by the National Cancer Institute that will evaluate the effectiveness of multi-level interventions to improve follow-up of abnormal stool-based cancer screening tests. In addition, his research program is leveraging digital health platforms to automate, tailor, and scale screening services to underserved populations.
Carly Rachocki, MPH
Questions & Answers
This program is a mail-based intervention using FIT kits designed to promote at-home and cost-effective colorectal cancer screening for all patients, including low-income and non-English-speaking individuals. The program components include the FIT kit, advanced notification of the FIT using postcards and/or calls, and follow-up using reminder prompts and calls.
In general, CRC screening is most effective when it includes multi-component and multi-level interventions that support the screening process at the patient, provider, and health system levels. Of the common activities (e.g., mailed FIT kits, paired flu vaccinations with FIT kits, patient navigation, notifications, and reminders), mailing FIT kits has been shown to be the most effective. Multiple reviews suggest an absolute percentage increase in screening test completion of 20% and up to 30% in specific scenarios.
In developing the program, we spoke with staff at clinics that had high screening rates and were performing outreach. We asked them about their outreach processes and materials. We used the lessons learned from their efforts to help design components of our program. We also spoke with the laboratory staff where the FITs were received and processed. Their feedback, and that of patient advisory boards, informed our outreach scripts and mailing components, including our wordless instructions for FIT completion.
The success of our program relied on an integrated health system with electronic health records. Through these records, we queried each patient’s screening status, eligibility for FIT mailing, and address and contact information. The operating procedures and materials were successfully used by the San Francisco Health Network during the COVID-19 pandemic.