Getting To Implementation: Improving Cancer Screening for Veterans

Gastrointestinal cancers such as colon cancer and liver cancer cause many deaths in the US. Testing could catch these cancers early, helping people live longer. The goal of this study is to compare two different ways of getting more people tested for these cancers: 1) by directly reaching out to the people who need testing or 2) by helping providers fix issues that hold up testing. The main question it aims to answer is: how should healthcare systems go about choosing one or the other? Researchers will look at cancer testing rates over time at sites that are trying these different approaches. They will also survey and interview participants from these sites.

Inclusion Criteria: 1. Veterans: * ≥18 years of age * Enrolled in Veterans Health Administration (VA) * Have ≥1 VA encounter in the prior 18 months * Hepatocellular cancer (HCC) screening subgroup: Diagnosis of cirrhosis in electronic medical record * Colorectal cancer (CRC) screening subgroup: ≥45 years of age, positive fecal immunochemical test (FIT) (or other screening stool test) in the last 18 months 2. Providers: * Healthcare provider or related staff at participating VA site or engaged in CRC or HCC screening pathways in an included VA site (e.g., scheduling) * ≥18 years of age Exclusion Criteria: 1. Veterans: * \