Mailed Invites May Boost Colon Cancer Screening Rates: Study
Offering a free colonoscopy or at-home test increased participation among uninsured
Monday, August 5, 2013
The researchers also found that encouraging people to use an at-home noninvasive screening test, such as a fecal immunochemical test (FIT), might be a better way to increase screening rates than promoting the more time-consuming and invasive colonoscopy.
The study included nearly 6,000 uninsured patients, aged 54 to 64, in a safety-net health system. The participants, who had not had a recent colorectal cancer screening, were mailed invitations to either complete a free FIT that was mailed to them and could be returned to the lab at no cost, or to schedule a free colonoscopy.
The mailing campaign resulted in a threefold increase in the use of FIT and a twofold increase in colonoscopies, compared with the usual care approach for colorectal cancer screenings, according to the study published online Aug. 5 in the journal JAMA Internal Medicine.
The findings suggest that large-scale public health efforts to increase colorectal cancer screening may be more successful if noninvasive tests are offered over colonoscopy, said study leader Dr. Samir Gupta, an associate professor of clinical medicine and gastroenterologist at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System.
"Physicians shouldn't necessarily assume that use of colonoscopies is the best and only way to reduce colon cancer rates," Gupta said in a university news release. "What we should ask is, what type of screening is most acceptable to underserved populations? This is because the best predictor of colorectal cancer screening outcomes may be getting any test, rather than which test is done," he explained.
But study senior author Celette Sugg Skinner, an associate director of population research and cancer control for the Simmons Cancer Center at UT Southwestern Medical Center in Dallas, pointed out that "the question to be studied further is whether superior participation can be maintained in the FIT group, because the test must be repeated every year, and how adherence rates will impact overall screening effectiveness and cost."