Increased rates of colorectal cancer screening seen for patients who received mailings

Colorectal cancer screening rates improved with patient mailings, which may be a useful tool for promoting screening, according to findings from a new study. Electronic physician reminders also promoted screening but only in patients who had frequent primary care visits.

The researchers enrolled patients aged 50 years to 80 years (n=21,860) and primary care physicians (n=110) in a randomized trial. All patients were overdue for colorectal cancer screening.

Patients were randomly assigned to receive mailings that contained an educational pamphlet, fecal occult blood test kit and instructions for direct scheduling of flexible sigmoidoscopy or colonoscopy. Researchers also randomly assigned physicians to receive electronic reminders during office visits with overdue patients.

Patients who received mailings had a 44% screening rate vs. 38.1% for patients who did not receive mailings (P<.001). For patients of physicians receiving reminders, the screening rates were 41.9% compared with 40.2% for patients of physicians not receiving reminders (P=.47).

Screening rates were higher (59.5%) for patients with three or more primary care visits compared with those who had less visits (52.7%; P=.07). Adenomas were detected in 5.7% of patients who received mailings vs. 5.2% without mailings (P=.10), according to the researchers. With physician reminders, adenomas were detected in 6.0% vs. 4.9% without reminders (P=.09).

“These complementary approaches have the potential to promote the overarching goal of widespread screening to reduce the incidence, morbidity and mortality of colorectal cancer,” the researchers wrote.

Arch Intern Med. 2009;169:364-371.