Program to Improve Colorectal Cancer Screening in a Low-Income, Racially Diverse Population: A Randomized Controlled Trial

The Article in Brief

Muriel Jean-Jacques , and colleagues

Background Nearly one-half of eligible adults are not up to date on colorectal cancer screening. This is particularly a problem among racial and ethnic minorities. This study examines the effectiveness of mailing fecal occult blood test (FOBT) kits to community health center patients who are overdue for colorectal cancer screening.

What This Study Found Direct mailing of fecal occult blood test kits to patients eligible for colorectal cancer screening appears to improve screening in historically underserved communities. Patients who receive FOBT kits in the mail with follow-up telephone calls to initial nonresponders have a 30 percent screening rate, compared with a 5 percent screening rate among patients in the usual care group.

Implications

• Prior studies have shown that direct-to-patient mailing of FOBT kits can lead to higher colorectal cancer screening rates in predominantly white, middle-class or well-insured populations. This study demonstrates that the strategy can significantly improve screening rates among economically disadvantaged patients from a wide range of racial, ethnic, and cultural backgrounds.