Mailed outreach invitations resulted in higher colorectal cancer screening compared with usual care, according to a study.
The study, by first author Samir Gupta, MD, ACP Member, of the Veterans Affairs San Diego Healthcare System, and the University of California, San Diego, and colleagues, appeared online Aug. 5 at JAMA Internal Medicine.
Nearly 6,000 uninsured participants in 13 clinics in Fort Worth and Tarrant County, Texas, who were out of date with the colorectal screening compliance were randomly assigned to one of three groups: 1,593 to outreach for fecal immunochemical screening consisting of mailed invitation to use and return an enclosed no-cost FIT with telephone follow-up, 479 to outreach for no-cost colonoscopy screening with telephone follow-up, and 3,898 to usual care consisting of opportunistic primary care visit-based screening. Researchers measured any colorectal cancer screen within one year after outreach.
Screening participation was 40.7% higher for FIT and 24.6% for colonoscopy outreach than the 12.1% rate for usual care. The number needed to invite to gain 1 additional screening over usual care was 8 for colonoscopy and 3.5 for FIT. The results held when broken down by race as well, the authors noted.
Authors wrote, “FIT outreach tripled colorectal cancer screening rates, and colonoscopy outreach doubled the rates compared with usual care. 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.”