Among underserved patients whose colorectal cancer (CRC) screening was not up to date, mailed outreach invitations appear to result in higher CRC screening compared with usual care, according to a study by Samir Gupta, M.D., M.S.C.S., of the Veterans Affairs San Diego Healthcare System, and the University of California, San Diego, and colleagues.
A total of 5,970 participants were randomly assigned to one of three groups: 1,593 to fecal immunochemical test (FIT) outreach, 479 to colonoscopy outreach, and 3,898 to usual care. Researchers measured for screening participation in any CRC test within one year after outreach was conducted.
Screening participation was significantly higher for both FIT (40.7 percent) and colonoscopy outreach (24.6 percent) than for usual care (12.1 percent). In stratified analyses, screening was higher for FIT and colonoscopy outreach than for usual care, and higher for FIT than for colonoscopy outreach among whites, blacks, and Hispanics, according to the study results.
"This prospective, randomized, comparative effectiveness trial demonstrated that organized mailed outreach efforts substantially increased CRC screening participation among underserved patients. FIT outreach tripled CRC screening rates, and colonoscopy outreach doubled the rates compared with usual care," the study concludes. "For underserved populations, our findings raise the possibility that large-scale public health efforts to boost screening may be successful if noninvasive tests, such as FIT, are offered over colonoscopy," the study concludes.
JAMA Intern Med. Published online August 5, 2013. doi:10.1001/jamainternmed.2013.9294