Outreach invitations for FIT and colonoscopy improve colorectal cancer screening rates: A randomized controlled trial in a safety‐net health system

BACKGROUND The effectiveness of colorectal cancer (CRC) screening is limited by underuse, particularly among underserved populations. Among a racially diverse and socioeconomically disadvantaged cohort of patients, the authors compared the effectiveness of fecal immunochemical test (FIT) outreach an...

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Bibliographic Details
Published in:Cancer 2016-02, Vol.122 (3), p.456-463
Main Authors: Singal, Amit G., Gupta, Samir, Tiro, Jasmin A., Skinner, Celette Sugg, McCallister, Katharine, Sanders, Joanne M., Bishop, Wendy Pechero, Agrawal, Deepak, Mayorga, Christian A., Ahn, Chul, Loewen, Adam C., Santini, Noel O., Halm, Ethan A.
Format: Article
Language:English
Subjects:
Adult
Aged
colonoscopy
Colonoscopy - statistics & numerical data
colorectal cancer screening
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - prevention & control
Early Detection of Cancer - methods
Early Detection of Cancer - statistics & numerical data
fecal immunochemical test
Female
Humans
Immunohistochemistry
Male
Mass Screening - methods
Mass Screening - statistics & numerical data
Middle Aged
navigation
Occult Blood
Primary Prevention - methods
randomized controlled trial
safety‐net health system
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Summary:BACKGROUND The effectiveness of colorectal cancer (CRC) screening is limited by underuse, particularly among underserved populations. Among a racially diverse and socioeconomically disadvantaged cohort of patients, the authors compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase screening participation rates, compared with usual visit‐based care. METHODS Patients aged 50 to 64 years who were not up‐to‐date with CRC screening but used primary care services in a large safety‐net health system were randomly assigned to mailed FIT outreach (2400 patients), mailed colonoscopy outreach (2400 patients), or usual care with opportunistic visit‐based screening (1199 patients). Patients who did not respond to outreach invitations within 2 weeks received follow‐up telephone reminders. The primary outcome was CRC screening completion within 12 months after randomization. RESULTS Baseline patient characteristics across the 3 groups were similar. Using intention‐to‐screen analysis, screening participation rates were higher for FIT outreach (58.8%) and colonoscopy outreach (42.4%) than usual care (29.6%) (P
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.29770