Inclusion Criteria:

- Age 50 to 75

- No documentation of previous CRC screening (FOBT, flexible sigmoidoscopy, or
colonoscopy)

- Preferred language English or Spanish

- 2 visits to Erie Family Health Center in the past 2 years

Exclusion Criteria:

- Any of the following:

1. colonoscopy within 10 years

2. flexible sigmoidoscopy within 5 years

3. a clinician order or referral for FOBT prior to the due date (indicating concern
for gastrointestinal bleeding)

4. medical conditions suggesting CRC screening through FOBT may be inappropriate,
including chronic diarrhea, inflammatory bowel disease, iron deficiency,
previous colonic polyp, use of medications in the previous 1 month that elevate
the risk of a false-positive FOBT (i.e., plavix or warfarin), and medical
conditions that make CRC screening inappropriate (metastatic cancer or previous
total colectomy)