(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) vs. colonoscopy, according to a study published online Aug. 5 in JAMA Internal Medicine.
Samir Gupta, MD, 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 54–64 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% for FIT; 24.6% for colonoscopy) vs. usual care (12.1%), 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% for FIT and colonoscopy outreach and 0.2% for usual care, while the corresponding rates for advanced adenoma detection were 0.8, 1.3, and 0.4% (P<0.05 for colonoscopy vs. 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.”