Randomized trial of patient navigation to improve colonoscopy completion after an abnormal stool test result

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. The randomized PRECISE study, at 32 clinics in Washington State, randomized persons aged 50 to 75 years with an abnormal fecal test result in the prior month to a telephone-based, 6-topic, patient navigation program (n=479) or usual care (UC; n=488). Primary endpoint was completion of follow-up colonoscopy at 1 year. Receipt of follow-up colonoscopy was higher in the patient navigation group than in the UC group (55.1% versus 42.1%; risk difference 13.0 percentage point; 95% CI 6.5-19.4). A limitation was that the study was primarily done during the height of the COVID-19 pandemic, which created additional barriers to colonoscopy. The authors conclude that these findings support the effectiveness of patient navigation for follow-up colonoscopy completion.