In low-income and minority communities where colonoscopies may be prohibitively expensive for many residents, less-invasive, more frequent testing combined with automated reminders can yield dramatic improvements in colorectal cancer (CRC) screening rates, according to a new Northwestern Medicine study.
The study found that community health center patients who received follow-up – outreach by mail, automated telephone and text messages, and calls by a health center staff member if no response was given in three months – were more than twice as likely to complete an at-home colon cancer screening test. This was true even though most patients in the study were poor, uninsured, had limited English proficiency and a low understanding of health information. The study was published in JAMA Internal Medicine on June 16.
“With electronic health records, we can set up inexpensive systems to remind patients to do annual home colon cancer screening tests and achieve a very high success rate,” said the study’s author Dr. David Baker. “We can achieve success even for patients with multiple financial, literacy, and cultural barriers to CRC screening.”
CRC is the third most common cancer for both men and women and the second-leading cancer killer in the United States. Screening and early treatment can be extremely successful in preventing CRC deaths; approximately 90 percent of people with CRC that is found early and treated appropriately are still alive five years later.
In the U.S., the majority of CRC screening is done by colonoscopy, even though the procedure is expensive and invasive, and several safe and effective recommended alternatives exist. In this study, Baker’s team used fecal occult blood testing (FOBT), which can be completed at home with a single stool sample. FOBT must be conducted annually to catch colon cancer before it is too advanced to cure. Prior to the study, it was not known whether patients would adhere to an annual at-home testing schedule for CRC.
Dr. Baker and his colleagues identified 450 patients who received their care through a network of community health centers in Chicago. The overwhelming majority of the patients studied were uninsured Latino women and all had had a negative result with a previous at-home FOBT.
The researchers found that the intervention was very successful, with 82.2 percent of the patients in the intervention group completing the FOBT within six months of the screening due date compared to 37.3 percent of the patients in the usual care group.
For more information, visit: http://www.feinberg.northwestern.edu/news/2014/06/david_baker_colon_cancer.html