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A stool test mailed to your home. That is the intervention.
No clinic visit. No prep. No procedure. Just a kit in the mailbox and the choice to use it.
New research published in JAMA Network Open this week put hard numbers on exactly how much that choice matters, and the data stopped me cold.
Researchers from the Karolinska Institutet in Stockholm tracked 376,511 people over a 13-year study period. They compared people invited to colorectal cancer screening to those who were not. Then they looked at who actually participated.
Here is what they found, according to Clinical Briefing Report:
– Being invited to screening: 26% lower colorectal cancer mortality
– Actually participating in screening: 43% lower colorectal cancer mortality
– Mortality rate ratio for invitation: 0.74
– Mortality rate ratio for participation: 0.57
“Our study highlights the importance of taking part in colorectal cancer screening, and shows that it can actually save lives,” said lead researcher Johannes Blom, M.D., Ph.D.
Think about that gap for a second.
Invitation alone saves lives. Participation saves more. The delta between those two numbers is the access problem. It is the trust problem. It is the outreach problem. It is the exact problem that keeps me up at night when I think about underserved communities and lung cancer, not just colorectal.
🎯 The Screening Participation Framework: three levers, one outcome
1. Awareness: Does the patient know screening exists for them?
2. Access: Can they actually complete it without barriers?
3. Activation: Does someone guide them through follow-through?
Every point of mortality reduction lives in closing the gap between those three levers. That is the entire game.
At Oatmeal Health, we obsess over this with lung cancer screening. The communities least likely to get screened carry the highest burden of disease. We see the same pattern here with colorectal. Low-friction screening, like a mailed stool kit, should be the floor, not the ceiling.
⚡ The real story is not the 43%. It is the people who never got the invitation.
The study design compared those invited between 2008 and 2012 to those invited later or never invited. The never-invited group represents the gap we need to close. That is not a clinical problem. That is a systems and equity problem.
Save this post if you work in cancer screening program design. The three-lever framework above applies directly to your outreach strategy.
Screening works. We have always known that. What we are still figuring out is how to make it work for everyone, not just those lucky enough to get the invitation.
👉 Follow Jonathan Govette, CEO of Oatmeal Health, for daily healthcare insights on LinkedIn. Deeper dives in The Oatmeal Bite on Substack: https://news.oatmealhealth.com
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Author:
CEO/Co-Founder @ Oatmeal Health | AI Lung Cancer Screening | Almost Became a Doctor | Engineer | Follow to Share What I’ve Learned Along the Way
I help patients get the care they need earlier, preventing late-stage cancer.
That’s been the throughline across three companies and almost 20 years in healthcare. At ReferralMD, we fixed broken referral networks so patients didn’t fall through the cracks. At Oatmeal Health, it’s lung cancer: building the diagnostic and screening infrastructure so the 85% of cases caught too late get caught early instead.
Today as CEO of Oatmeal Health, I lead a team embedding AI into radiology workflows to turn routine lung CT scans into reimbursable cancer risk assessments. We partner with FQHCs to reach underserved communities, and with health systems and payers to make early detection economically sustainable. Think HeartFlow or Cleerly, but for lungs.
Between companies, I advised at Techstars and Plug and Play, mentoring founders building in digital health. That experience shaped how I think about what separates companies that ship from companies that stall: distribution, reimbursement, and clinical trust, not just technology.
I’m a CancerX alumnus, a 3x healthcare founder, and someone who believes the biggest problems in cancer aren’t scientific. They’re operational.
We’re hiring mission-driven builders at Oatmeal Health. If you want to work on something that matters, reach out.
When I’m not working, I’m traveling, mentoring, and keeping up with one very energetic husky. 🐾
Substack – The Oatmeal Bite:
Millions of patients get less care because of who they are, where they live, or how they look. I’m fighting to change that. CEO @OatmealHealth, a startup built for the underserved. The Oatmeal Bite: intel for clinicians, investors, and advocates.
Jonathan Govette
CEO of Oatmeal Health
Substack:
https://oatmealhealthjonathangovette.substack.com/
