Systematic Technique for Increasing Colorectal Cancer Screening Rates

Patients’ lives are saved each year through screening for early detection of colorectal cancer (CRC). However, in 2010 only 65% of US adults between the ages of 50 and 75 years received this cost-effective, recommended screening.

Now a University of Colorado Cancer Center study demonstrates a systematic approach to improve screening rates.

“With an introductory phone call and then mailed testing kits, we saw CRC screening rates jump from 47% to 72% in 3 years. Those who were exposed to the outreach were almost 4 times more likely to screen,” says Karin Kempe, MD, MPH, recent director of clinical prevention at Kaiser Permanente Colorado, a CU Cancer Center consortium partner.

For the study, Kempe and colleagues mailed 58,800 fecal immunochemical tests (FIT) to low-risk Kaiser members who were not up to date on CRC screening. Members had a choice to either complete the stool test at home and return it via mail or request colonoscopy through their medical provider. Study results, published in the American Journal of Managed Care, show that of these hard-to-convince patients, 26,003 completed screening with a FIT or colonoscopy.

The increase in screening rates was especially high in those without recent primary or specialty care visits, suggesting that the protocol reached patients who may have been unaware of screening recommendations or who were not previously engaged in preventive care. Furthermore, patients screened first through this study tended to migrate over time into the colonoscopy screening program.

Still, “while those groups that usually have lower rates of screening, such as African Americans or Latinos, did improve, their response was less than in the white and Asian populations,” Kempe adds. “But continued effort and investment in this area is definitely required.”

According to Kempe, before starting a system like this, low-risk patients appropriate for FIT must be identified, and a system for tracking and managing the results of a massive number of screening kits must be in place. But results of the current study indicate that, when implemented carefully, a protocol of phone calls and mailed kits can increase colorectal cancer screening. And, greater screening rates can potentially result in lower costs and better medical outcomes for program participants.

Source: University of Colorado Cancer Center.