July 17, 2018
2 min read

Mailed FIT kits nearly double colon cancer screening rates

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Mailing fecal immunochemical tests directly to patients insured by Medicaid helped improve colorectal cancer screening rates, according to research published in Cancer.

Alison T. Brenner, PhD, MPH, of the Lineberger Comprehensive Cancer Center at the University of North Carolina Chapel Hill, and colleagues wrote that despite the benefits of early detection, less than two-thirds of eligible patients undergo CRC screening.

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

In a patient-level randomized trial, Brenner and colleagues sought to determine if a new outreach program could help improve screening rates among patients insured by Medicaid. They identified patients at average risk for CRC and no evidence of screening with Medicaid claims and sent a screening reminder to each patient. One group of patients also received a FIT kit along with their reminder (n = 764), while the other group received just the reminder (n = 726). The primary outcome of the study was FIT return.

In the group that received a FIT kit, 161 patients returned a screening test, whereas 89 patients in the reminder-only group later underwent FIT screening (21.1% vs. 12.3%; difference 8.8%; 95% CI, 3.7–13.9). Brenner and colleagues found that patients who received the FIT kit were 1.72 times more likely to complete the FIT than patients who did not (95% CI, 1.35–2.18; P < .01).

Investigators found that 18 of the patients who submitted a FIT across both groups had abnormal results, and 10 of 15 patients who were eligible for colonoscopy completed that follow-up.

Brenner and colleagues worked with the Mecklenburg County Health Department in North Carolina to coordinate the reminders and mailings. Brenner said it was a good opportunity to showcase how to use existing resources to improve cancer screenings, and her group has plans to continue their research and determine if their approach can be taken to a larger scale.

“This is looking at expanding the medical neighborhood — to harness community resources to target patients and in this case, insured patients, who are maybe not getting this from a primary health care organization, and how to increase screening rates in these types of vulnerable populations,” she said in the press release. – by Alex Young

Disclosures: The authors report no relevant financial disclosures.