DOI

10.21007/con.dnp.2026.0136

Faculty Advisor

Bobby Bellflower, DNSc, NNP-BC-FAANP, FNAP, FAAN

Document Type

Poster

Publication Date

Spring 4-28-2026

Disciplines

Health and Medical Administration | Investigative Techniques | Medicine and Health Sciences | Nursing | Nursing Administration | Quality Improvement

Abstract

Purpose/Background 

Colorectal cancer (CRC) remains a significant public health concern in the United States, with screening rates below national targets due to persistent socioeconomic and structural barriers, particularly among underserved populations. Stool-based screening modalities offer accessible alternatives to colonoscopy, and emerging evidence suggests that home-based delivery models may improve screening uptake; however, implementation strategies vary and comparisons between home-based and clinic-based approaches remain limited. This scoping review examines current evidence on strategies that support CRC screening uptake, with a focus on stool-based modalities, including fecal immunochemical testing (FIT), fecal occult blood testing (FOBT), and multitarget stool DNA testing (mDNA), and their delivery models among adults aged 45 years and older.

Methods 

This scoping review adhered to PRISMA-ScR guidelines. Eligible evidence included studies and guidelines reporting on CRC screening uptake using stool-based modalities (FIT, FOBT, or mDNA) and related implementation strategies. Peer-reviewed literature and authoritative sources were identified through structured searches and supplementary materials. Records were screened using predefined eligibility criteria, with independent data extraction into a structured charting table capturing study characteristics, screening modality, interventions, and screening outcomes.

Results 

Following duplicate removal and screening, 14 studies were included. Most demonstrated increased CRC screening compliance and improved early detection, particularly when stool-based testing was paired with educational interventions, reminders, or navigation support. Socioeconomic barriers to screening participation were commonly identified. In contrast, outcomes related to harm, cost-effectiveness, and patient satisfaction were inconsistently reported.

Implications for Nursing Practice 

Overall, findings indicate that stool-based screening is most effective when paired with patient-centered strategies, including mailed outreach and culturally responsive education.

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