Race and Medicine
Race and Medicine
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Disclosures: The authors report no relevant financial disclosures.
August 12, 2020
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Mailed tests, follow-up calls increase colorectal cancer screening among African Americans

Source/Disclosures
Disclosures: The authors report no relevant financial disclosures.
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Mailed stool blood tests and follow-up phone calls are examples of effective strategies that increased colorectal cancer screening among African Americans, according to findings of a systematic review.

Even though colorectal cancer screening and treatment have improved, mortality rates associated with the disease are 47% higher in African-American men and 34% higher in African-American women compared with non-Hispanic whites, according to Siddhartha Roy, MPH, DrPH, assistant professor in the department of family and community medicine at Penn State University.

Strategies to increase colorectal cancer screening among African Americans include patient navigators making phone calls; clinical staff distributing tailored educational materials; and health care workers providing patients with a tailored decision aid, video, printed materials and/or fecal immunochemical test kit.
Reference: Roy S, et al. J Community Health. 2020;doi:10.1007/s10900-020-00867-z.

Although medical organizations like the U.S. Preventive Services Task Force (USPSTF), the American Academy of Family Physicians and the American Cancer Society all recommend stool blood testing for colorectal cancer, 2018 data indicate that the screening rate in the United States is 5.3% behind the Healthy People 2020 target of 70.5%.

Siddharta Roy
Siddharta Roy

“We identified a gap in the current literature regarding the effectiveness of [colorectal cancer] stool blood screening interventions among African Americans,” Roy told Healio Primary Care.

To address that gap, Roy and colleagues reviewed 11 experimental studies that included 4,364 participants — 3,334 of whom were African American. They found that colorectal cancer screening rates from baseline increased:

  • 27% after receiving a telephone call;
  • 30% after using a decision aid;
  • 44% after watching an educational video; and
  • 82% after receiving a tailored print intervention and a fecal immunochemical test kit.

The effectiveness of these interventions, measured by ORs, ranged from 1.1 to 13.

“Based on the findings from this systematic review, implementing [colorectal cancer] screening interventions in clinic-based settings may be an effective strategy for increasing screening uptake among African Americans, potentially due to clinical interactions, audit and feedback systems, or other electronic means to remind patients of screening appointments,” Roy said. “Utilizing tailored patient navigation approaches was also found to be effective in increasing screening uptake among African Americans.”