A study, published in JAMA, examined which strategy was most effective in promoting colorectal cancer screening among individuals who were not current with their screening.
Amit Singal, MD, of Dallas-based University of Texas Southwestern Medical Center, and colleagues conducted a pragmatic, randomized clinical trial of 5,999 out-of-date colonoscopy participants between 50 years and 64 years at Dallas-based Parkland Health and Hospital System.
Researchers mailed both fecal immunotherapy testing and colonoscopy reminders to the patients or they offered the procedures during usual care with clinical-based screening. Researchers measured for screening process completion. All participants were included in an intention-to-screen analysis.
Here's what they found:
1. Around 38.4 percent of patients completed the screening process in the colonoscopy outreach group, 28 percent in the FIT outreach group and 10.7 percent in the usual care group.
2. Both outreach groups had higher completion rates than the usual care group. The colonoscopy outreach group had the highest completion rate when compared to the other groups.
3. Compared with usual care, adenoma and advanced neoplasia detection rate was higher among both outreach groups. The colonoscopy group had the highest rate at 10.3 percent for adenomas and 3.1 percent for advanced neoplasia.
4. Researchers reported no "screening-related harms."
Researchers concluded, "Among persons aged 50 to 64 years receiving primary care at a safety-net institution, mailed outreach invitations offering FIT or colonoscopy compared with usual care increased the proportion completing CRC screening process within three years. The rate of screening process completion was higher with colonoscopy than FIT outreach."
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