University of Kentucky Rural Cancer Prevention Center

Mail-in Kit Being Used for Early Detection of Colon Cancer – Rural Cancer Prevention Center


Colorectal cancer, also known as colon cancer, is the second leading cancer killer for men and women in the U.S. combined. In rural areas, residents typically experience higher rates of colon cancer and death from colon cancer.  In Appalachian Kentucky, for example, 21 of every 100,000 people die from colon cancer. This number exceeds the death rate for the entire state (18 per 100,000) and the U.S. (15 per 100,000). To address this public health concern, researchers from the University of Kentucky Prevention Research Center (PRC) plan to encourage widespread use of annual colon cancer screening with Fecal Immunochemical Test (FIT) in the Kentucky River Area Development District (KRADD).

Researchers will compare a community-level FIT intervention in the KRADD to the standard use of FIT in a similar district called the Cumberland Valley Area Development District (CVADD). Local Health Departments in each district will be given FIT kits to distribute to people ages 50 to 75 who have not been screened for colon cancer. Each person who takes a kit will receive a reminder phone call to return their specimens, if they have not done so after seven days. The KRADD intervention will also link distribution to flu shot vaccinations and mammograms, use PRC staff community outreach, and 40 change agents (i.e., colon cancer survivors in the KRADD or those who received a colonoscopy with negative results) to promote FIT use.

These approaches will be used until 500 test results are collected. Then, to achieve an effective model for annual screening with FIT, researchers will take a portion of the 500 and enroll them in a research study. The study will,

  1. identify characteristics of good peer leaders in the KRADD to become change agents,
  2. test a navigation strategy to get those who tested FIT-positive linked to counseling services and medical care, and
  3. establish a social media approach, using Facebook, that will support annual repeat use of FIT.

For both the CVADD and the KRADD, the amount of FIT specimens returned (i.e., rate will be calculated, number returned/number distributed), the percentage of those that are valid, and the time it took to return them will be collected and analyzed. The results will help determine community effect size differences for the KRADD intervention versus the standard of care approach used in the CVADD. After successful testing, researchers plan to disseminate and implement FIT statewide as well as throughout Central Appalachia.

Project Identifier Novel Intervention Approaches to Prevent Death from Colorectal Cancer in Rural America

Funding Source PRC Program

Project Status Active

Host Institution University of Kentucky

Health Topics Cancer

Research setting Rural area

Race or ethnicity No specific focus

Gender No specific focus

Age group Older adults (50 years and older)

Contact Information Center

Rural Cancer Prevention Center

151 Washington Avenue

Lexington, KY 40506


Principal Investigator

Richard Crosby  


PRC Deputy Director

Tom Collins

Phone: (859) 218-2238