Smartphone-enabled Hybrid Identification of Early CoLorectal Disease Using Blood-Based Cancer Testing Across TeXas

The goal of this prospective implementation study is to understand the impact of a blood-based screening test (BBST) for colorectal cancer (CRC) on patient acceptability of and adherence to CRC screening as well as the rate of follow-up BBST in those with negative BBST at a 1-year interval. Additional aims include assessing the impact of digital patient navigation intervention on the rate of follow-up colonoscopy in individuals with positive BBST. Patients will be randomized into the non-intervention arm or the intervention with an app arm.

Inclusion Criteria: * patients aged 45-84 years of age * Considered by health-care providers to be "average risk" for CRC as determined by USPSTF guidelines * If a patient opts for BBST, they are able and willing to provide blood samples per protocol * Ability to understand and the willingness to participate in the study * Must have been seen in HTPN clinic within the past 24 months from study activation * Must have active MyBSW app portal account and/or establish account during study recruitment Exclusion Criteria: * Patients with a personal history of CRC * Patients with a known high-risk family history of CRC precluding the patient from being average risk * Patients with known diagnosis of inflammatory bowel disease or history of polyps * Patients who are currently symptomatic for CRC such as: blood in the stool * Patients with any known medical condition which, in the opinion of the investigator, should preclude enrollment into the study * Have a recorded up to date CRC screening in the EMR (within 1 year for FIT, 3 years for mt-sDNA, 10 years for colonoscopy) * Patients with a previous abnormal colonoscopy finding who are due for surveillance.