Department of Family and Community Medicine University of California, San Francisco CA 94143-0900



1. What are the most important elements for a successful FluFIT Program?

The most important element for success is your passion and commitment to make it happen. Support and enthusiasm from the leadership of your healthcare organization, your clinic, and the members of your team are equally important. Other helpful tips include starting your planning process early, involving representatives of the entire clinic  in the planning process, and doing a careful walkthrough of all the required procedures prior to implementation.

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2. What are the national guidelines for flu shots?

The Centers for Disease Control and Prevention currently recommends that everyone over the age of 6 months should receive annual influenza vaccination. More information is posted on the CDC website:

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3. What are the national guidelines for colorectal cancer screening?

The US Preventive Services Task Force recommends colorectal cancer screening for all adults between the ages of 50 and 75. Healthy individuals may choose to continue screening until age 85. The recommended tests include FIT every year or colonoscopy every 10 years, as well as other options  Each recommended  screening strategy, if well-implemented,  can be similiarly effective in reducing colon cancer deaths.

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4. What is the difference between FIT and FOBT?

Guaiac fecal occult blood tests, also known as gFOBT, are still in use for colorectal cancer screening in many settings in the United States. These older tests typically with characteristics that require patients to restrict their diet and medication intake for several days prior to testing and involve the collection of three stool samples.  While inexpensive, they can be difficult for patients to complete successfully, and the return rate is often very low. Fecal immunochemical tests, known as FIT, are a newer type of FOBT that tests specifically for human hemoglobin in stool and which do not require food or medication restriction prior to taking the test.  FIT usually only requires one or two stool samples to complete. FIT is also very inexpensive, but slightly more expensive than gFOBT.  However, the improved patient acceptability, lower false positive rate, and higher return rate for the most effective brands of FIT will, in most cases make FIT more cost effective and a better choice than gFOBT.

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5. How much does it cost to implement a FluFIT Program?

In most cases, FluFOBT and FIT Programs require relatively few resources and are inexpensive to implement. Setting up a system to bill insurance plans for FIT may offset some of the costs of the program.


6. Why not offer FIT at every visit and not just during flu shot season?

It is a terrific idea to offer FIT  to eligible patients during every visit, if you have the time, staffing, and resources to do it. FluFIT Programs work best in settings that have not done a lot of outreach in the past or that don’t have resources to reach every patient with every needed service during every clinic visit.  Several organizations that have started out with the FluFIT Program have expanded the offering of FIT into year-round activities.  But even if you already have other ways to reach patients with FIT during routine office practice,  FluFIT Programs can be useful.  FluFIT Programs reach many patients who may otherwise not have an opportunity to get screened. It gives patients the message that “just like a flu shot, I need FIT every year.”

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7. What if we want to offer other preventive services besides FIT with flu shots?

Incorporating other preventive services into your  FluFIT activities can be an excellent idea. For example, you can consider providing other needed immunizations, providing mammogram referrals, offering smoking cessation services, or blood pressure screenings at the time of flu shots. Several organizations have done this successfully.  However, it may be easiest to start out by offering just one or two preventive services with your annual flu shots at first to avoid overwhelming your staff, patients, and available resources.