Translation of an Efficacious Cancer-Screening Intervention to Women Enrolled in a Medicaid Managed Care Organization

Dr. Dietrich and colleagues are to be congratulated for conducting a practical clinical trial of the impact of cancer screening incentives within the constraints of active clinical practice in an HMO setting in low income women. Their original research found significant improvement in breast, cervical, and colorectal cancer screening rates with a prevention care management intervention which was resource intensive to run outside a research setting. The authors have been able to develop a program which is less intensive and doable within a clinical practice setting and yet which still delivers an impact on colorectal cancer screening. This new study is a randomized trial of a scripted assistance for resolving barriers and scheduling appointments compared to an educational fact sheet approach. The implication of this work is that even a limited telephone intervention with scripted texts for dealing with barriers in screening and scheduling assistance can increase participating in colorectal cancer screening in a low income population. We know that colorectal cancer screening can reduce colorectal cancer mortality but such screening is completed by only half the population at risk. Participation is even lower in minority populations. The proposed intervention shows benefit in a minority population

Competing interests:   None declared