A RECENT trial has shown that a centralised, mailed colorectal cancer (CRC) screening programme significantly improved screening completion rates in federally qualified health centres (FQHCs) serving diverse patient populations.
The randomised clinical trial was conducted at 12 independent FQHC sites across North Carolina, USA from July 2020–September 2021. A total of 4,002 individuals were included, aged 50–75 years and at average risk for CRC. Participants were randomly assigned to either the intervention group or a control group receiving usual care. The intervention included mailed faecal immunochemical testing (FIT) kits, an introductory letter, instructions, return postage, and up to two reminder letters. Those who received abnormal results from the FIT test were offered assistance navigating follow-up colonoscopy.
Among participants in the intervention group, 30.0% completed the recommended CRC screening within 6 months, compared to just 9.7% in the control group (95% CI: 17.85–22.73 percentage points). Furthermore, among those with positive FIT results, 68.8% of intervention participants completed a colonoscopy within 6 months, compared to 44.4% in the control group (95% CI: −2.13–50.74 percentage points). Additionally, the intervention led to the detection of advanced colorectal neoplasia in 1.4% of intervention participants, compared to 0.7% in the control group (95% CI: 0.05–1.35 percentage points).
The findings highlight the effectiveness of centralised mailed outreach in improving CRC screening rates, potentially saving lives by detecting CRC earlier. Future studies will need to evaluate the cost-effectiveness and scalability of this approach to ensure its wider application across the USA.
Ada Enesco, EMJ
Reference
Reuland DS et al. Centralized colorectal cancer screening outreach in federally qualified health centers: a randomized clinical trial. JAMA Netw Open. 2024;7(11):e2446693.
