An inexpensive telephone intervention raised the rate of annual colorectal cancer screening using fecal occult blood testing to 82% in an underserved population at particular risk for poor health, according to a report published online June 16 in JAMA Internal Medicine.
In this clinical trial, 450 people aged 51-75 years (mean age, 60 years) treated at four Chicago community clinics were randomly assigned to either usual care or an intervention in which they were given take-home fecal immunochemical test (FIT) kits and followed by automated telephone or text message to encourage adherence. Most of the study participants were Hispanic (approximately 90%) and impoverished (91%); more than 75% of them were uninsured, said Dr. David W. Baker of the department of medicine, Northwestern University, Chicago, and his associates.
A total of 82.2% of the intervention group completed the FIT within 6 months – an annual screening rate that has been shown to reduce colorectal cancer mortality – compared with only 37.3% of the usual-care group. The median time to completion of the FIT was 13 days in the intervention group, compared with 83 days in the usual-care group. The estimated cost of the intervention was less than $35 per patient, the investigators said (JAMA Intern. Med. 2014 June 16 [doi:10.1001/jamainternmed.2014.2352]).
"Our study suggests that it is possible to achieve high annual FOBT adherence rates even among highly vulnerable populations," they said.
It is hoped that this strategy will reduce ethnic and socioeconomic disparities in colorectal cancer mortality, Dr. Baker and his associates added.
This study was funded by the Agency for Healthcare Research and Quality. No financial conflicts of interest were reported.