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Can Sending Tests to Patients in the Mail Improve Colorectal Cancer Screening?

By: Hillary Ojeda
Posted: Wednesday, August 8, 2018

Mailing colorectal cancer test kits with screening reminders to Medicaid patients produced more completed tests as opposed to sending reminders alone, according to research conducted by Alison Brenner, PhD, MPH, of the University of North Carolina (UNC) School of Medicine, and colleagues and published in the journal Cancer. They plan to study their approach further to find out whether it can be implemented on a larger scale and to understand the cost implications.

“There has been a national push to increase colorectal cancer screening rates since colorectal cancer is a preventable disease, but screening rates are only about 63%, and low-income, and otherwise vulnerable populations, tend to be screened at even lower rates,” said Dr. Brenner, according to an institutional press release.

Dr. Brenner and colleagues with UNC Lineberger Comprehensive Cancer Center worked in collaboration with the Mecklenburg County Health Department in Charlotte to analyze the efficiency of mailing reminders and tests to 2,144 patients insured by Medicaid. The patients were randomized into 2 groups: one group of 1,071 patients received the fecal immunochemical tests and the screening reminder, and another group of 1,073 patients received the reminder alone. The test kits, completed at home and delivered to a provider to be analyzed, confirmed whether the patients had blood in their stool.

Of the patients who received the test kits, 21% completed and returned them for analysis, compared with 12% who received a reminder alone. A total of 18 respondents who sent their kits for analysis had abnormal results, and 15 of them were eligible for follow-up colonoscopy. Of the 10 people who underwent colonoscopy, 1 had an abnormal result.

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