A more direct approach to exam reminders might boost colorectal cancer screening rates across the country, according to a University of North Carolina Lineberger team who found mailing patients screening kits improved testing rates over traditional reminder methods.
“There has been a national push to increase colorectal cancer screening rates since colorectal cancer is a preventable disease,” Alison T. Brenner, PhD, MPH, a research assistant professor in the UNC School of Medicine and the first author of a related study published in Cancer, said in a release. “But screening rates are only about 63 percent, and low-income, and otherwise vulnerable populations, tend to be screened at even lower rates.”
American Cancer Society guidelines recommend regular screening for colorectal cancer with either a high-sensitivity stool-based test or structural exam for those 45 years and older, Brenner said. Any positive results should be followed up with a colonoscopy.
But in spite of those somewhat rigid suggestions, research has confirmed low rates of colorectal cancer screening across the board. Race, region and socioeconomic status all seem to be variables, Brenner said—but Medicaid beneficiaries are the population with the lowest testing rates.
Brenner and her team at UNC Lineberger’s Carolina Cancer Screening Initiative partnered with the Mecklenburg County Health Department in Charlotte, North Carolina, to identify and reach out to 2,100 people insured by Medicaid who weren’t up-to-date with their colorectal cancer screenings. Certain patients were randomized to run-of-the-mill reminders, while others received both a reminder and a screening kit—a fecal immunochemical test, or FIT kit—in the mail.
Patients provided with a screening kit were prompted to take the test and return it to their healthcare provider for analysis and any relevant follow-up, according to the release. More than a fifth of those patients completed the test, compared to 12 percent of patients who received only a reminder. Eighteen patients reported abnormal results from the screening, and 15 colonoscopies led to one potential discovery of cancer.
The addition of a FIT kit to screening reminders for colorectal cancer led to a 9 percent hike in screening rates compared to traditional methods of alerting patients, Brenner said.
“Preventive care among vulnerable populations rarely rises to the top of the mental queue of things that need to get done,” she said. “In North Carolina, many Medicaid recipients are on disability. Making something like colorectal cancer screening as simple and seamless as possible is really important. If it’s right in front of someone, it’s more likely to get done, even if there are simple barriers in place.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.