Study: Aggressive outreach linked to improved colon cancer screening rates

Intensive outreach programs conducted through community health centers can significantly improve screening rates for colorectal cancer, according to a new study published in JAMA Internal Medicine.

Patients who received outreach via mail, automated phone and text messages and calls from a health center staff member were more than twice as likely to complete an at-home colon cancer screening test. This took place even though most patients in the study were poor and uninsured, and had limited English proficiency and low understanding of health information, according to the study.

Colorectal cancer is the third most common cancer for men and women, and the second-leading killer among cancers in the U.S.; Approximately 90 percent of people with such cancers that are found early and treated appropriately are still alive five years later. 

Researchers from the Center for Advancing Equity in Clinical Preventive Services, at the Feinberg School of Medicine at Northwestern University in Chicago, identified 450 patients from community health centers; they were typically uninsured Hispanic women who all had had a negative result with a previous at-home fecal occult blood test (FOBT). Divided into control and intervention groups, the latter group received usual care plus:

• A mailed reminder letter, a free home test with low-literacy instructions and a postage-paid return envelope.
• Automated phone and text messages reminding them that they were due for screening and that a home test was being mailed to them.
• Automated phone and text reminders two weeks later for those who did not return the home test.
• Personal outreach from a trained professional after three months if a test was not completed.

The researchers found that the intervention was very successful, with 82.2 percent of the patients in the intervention group completing the FOBT within six months of the screening due date versus 37.3 percent of the patients in the usual care group.

"Early screening is an important tool in fighting colorectal cancer, but only three fifths of U.S. adults age 50 to 75 overall are up to date on their screenings—and serious disparities persist by income, education, race/ethnicity and other groups," said Richard Kronick, PhD and director of the Agency for Healthcare Research and Quality, which supported the study. "Today's report indicates that intense outreach can increase screening and save lives."