Study of Patient Navigation to Promote Colon Cancer Screening

Inclusion Criteria: * Patients aged 52-75 who had one visit to a primary care physician in a community health center in each of the 2 previous years and who have not received colorectal cancer screening based on HEDIS criteria. Exclusion Criteria: * Current cancer diagnosis, undergoing treatment (or treatment completed within the past year) * Severe cardiac disease (high-risk CAD,9 valvular disease, NYHA Class III or IV CHF, EF \< 35%) * Severe COPD (FEV1\< 1liter or on home oxygen) * CVA with severe functional impairment (aphasia or hemiparesis) * MS with severe functional impairment * Renal failure with CrCl\< 30 or on dialysis * Gastrointestinal symptoms (pain, bleeding, etc) within the past 6 months * Chronic active liver disease or cirrhosis, with albumin \< 3 or elevated INR * Advanced HIV disease (CD4 count \<200) * Severe lupus (with cerebritis or renal failure as defined above) * Severe complications of diabetes (blindness, amputations other than toes) * Advanced Dementia * Psychosis * Paranoia * Active substance abuse * Schizophrenia * Psychiatric hospitalization within the past year