Invitation to CRC Screening Ups Participation in Underserved

Monday, August 5, 2013 (Last Updated: 08/06/2013)

MONDAY, Aug. 5 (HealthDay News) -- For an underserved population, an invitation to colorectal cancer (CRC) screening significantly improves screening rates, with significantly higher participation for fecal immunochemical test (FIT) versus colonoscopy, according to a study published online Aug. 5 in JAMA Internal Medicine.

Samir Gupta, M.D., from the Veterans Affairs San Diego Healthcare System, and colleagues assessed the impact of organized mailed outreach on CRC screening in a population of uninsured patients aged 54 to 64 years. A total of 1,593 participants were assigned to receive FIT outreach (mailed invitation to use and return an enclosed no-cost FIT); 479 were assigned to colonoscopy outreach (mailed invitation to schedule a no-cost colonoscopy); and 3,898 were assigned to usual care (opportunistic primary care visit-based screening).

The researchers found that screening participation was significantly higher for outreach (40.7 percent for FIT; 24.6 percent for colonoscopy) versus usual care (12.1 percent), and was significantly higher for FIT than colonoscopy. In stratified analyses, these correlations were significant for whites, blacks, and Hispanics. The rates for CRC identification were 0.4 percent for FIT and colonoscopy outreach and 0.2 percent for usual care, while the corresponding rates for advanced adenoma detection were 0.8, 1.3, and 0.4 percent (P < 0.05 for colonoscopy versus usual care advanced adenoma comparison).

"In conclusion, we found that organized outreach, including mailed invitation and telephone follow-up, was highly effective for boosting CRC screening among the underserved," the authors write. "Furthermore, outreach was almost twice as effective when FIT rather than colonoscopy was offered."

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