Trial results for the SMARTER CRC intervention, aimed at improving Colorectal Cancer screening, were posted on ClinicalTrials.gov on 2025-08-19, showing an 11.8% likelihood of any screening in the intervention group compared to 4.5% in usual care.
Background
Colorectal cancer (CRC) remains a significant public health concern, and early detection through screening is critical for improving patient outcomes. Despite established screening guidelines, disparities in screening rates persist, particularly in rural and underserved populations such as Medicaid patients. Interventions that can effectively adapt and scale up to improve screening rates, follow-up colonoscopy, and referral to care in these settings are essential to reduce the overall burden of colorectal cancer on the United States population.
Trial design
This completed study, designated as Phase NA, enrolled 5696 participants to investigate conditions including Colorectal Carcinoma. The study, titled "Screening More Patients for Colorectal Cancer Through Adapting and Refining Targeted Evidence-Based Interventions in Rural Settings, SMARTER CRC," aimed to provide a model for rapidly adapting and scaling up multilevel interventions via clinic-health plan partnerships. The goal was to improve colorectal cancer screening rates, follow-up colonoscopy, and referral to care in rural Medicaid patients. The intervention group, "SMARTER CRC Intervention Year 1," was compared against a "SMARTER CRC Usual Care" group.
Key results
The trial reported several key measurements related to colorectal cancer screening:
- Likelihood of Any Colorectal Cancer (CRC) Screening (for Study-eligible Patients):
- In the SMARTER CRC Intervention Year 1 group, the mean likelihood was 11.8 Percentage of participants.
- In the SMARTER CRC Usual Care group, the mean likelihood was 4.5 Percentage of participants.
- Completion of CRC Screening:
- In the SMARTER CRC Intervention Year 1 group, the mean completion rate was 16.8 Percentage of participants.
- In the SMARTER CRC Usual Care group, the mean completion rate was 9 Percentage of participants.
- Rate of CRC Screening Among the Intervention-eligible Population:
- In the SMARTER CRC Intervention Year 1 group, 181 Participants were reported.
- Time to Screening From Study-eligible Patient List Pull:
- In the SMARTER CRC Intervention Year 1 group, the mean time was 118.5 Days (Standard Deviation 293.9).
- In the SMARTER CRC Usual Care group, the mean time was 103.2 Days (Standard Deviation 383.2).
- Abnormal FIT Results:
- In the SMARTER CRC Intervention Year 1 group, there were 19 Participants with abnormal results.
- In the Usual Care group, there were 7 Participants with abnormal results.
- Patient Navigation Trainings (Intervention Group):
- In the SMARTER CRC Intervention Year 1 group, 22 Participants completed trainings.
- Patient Navigation Completed (Intervention Group):
- In the SMARTER CRC Intervention Year 1 group, 22 Participants completed navigation.
- Follow-up Colonoscopy Completion:
- In the SMARTER CRC Intervention Year 1 group, the completion rate was 49.1 Percent of participants.
What this means
The results of the SMARTER CRC study suggest that tailored multilevel interventions delivered through clinic-health plan partnerships can significantly improve colorectal cancer screening metrics in rural Medicaid populations. The intervention group demonstrated a higher likelihood of any CRC screening and a greater completion rate compared to usual care. The increased identification of abnormal FIT results in the intervention group also points to more effective screening engagement. These findings indicate a potential model for enhancing early detection efforts and reducing disparities in colorectal cancer care for underserved communities.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT04890054, titled "Screening More Patients for Colorectal Cancer Through Adapting and Refining Targeted Evidence-Based Interventions in Rural Settings, SMARTER CRC", were posted on 2025-08-19 on clinicaltrials.gov.