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Physician reminders significantly increase colorectal cancer screenings

General practitioners who were notified about which of their adult patients were not current with their colorectal cancer screening resulted in a small but significant increase in patients undergoing fecal immunochemical tests within 1 year, according to study findings recently published in JAMA.

“Prior work has examined patient-focused strategies to increase participation in [colorectal cancer] screening, such as postal mailing of screening kits, written or telephone reminders, and tailored navigation,” Cédric Rat, MD, PhD, of the department of general practice at the French National Institute of Health and Medical Research, and colleagues wrote in the JAMA study. “However, research has not sufficiently explored whether reminders directed to [general practitioners (GPs)] increases patient participation.”

Researchers randomly assigned 1,482 GPs in France to one of three groups: 455 did not receive any reminders (usual care group); 495 received a letter detailing region-specific colorectal cancer screening adherence rates (generic reminders group); and 496 received a list of patients who had not undergone [colorectal cancer] screening (patient-specific reminders group).

Rat and colleagues found that at 1 year, 20.6% (95% CI, 19.3-21.8) in the usual care group, 21.7% (95% CI, 20.5-22.8) in the generic reminders group and 24.8% (95% CI, 23.4-26.2) of patients in the specific reminders group underwent fecal immunochemical test screening.

In addition, the between-group differences were 1.1% (95% CI, –0.6 to 2.8) for generic reminders group vs. the usual care group, 4.2% (95% CI, 2.3-6.2) for the patient-specific reminders group vs. the usual care group and 3.1% (95% CI, 1.3-5) for the patient-specific reminders group vs. the generic reminders group. When compared to the usual care group, the generic reminder about regional screening rates had little impact on future screening rates.

“General practitioners may not focus their attention and energy on cancer screening because of concerns about other health issues. Perhaps patients who are not concerned about cancer screening also demonstrate a lack of time for health and prevention in general,” Rat and colleagues wrote. “Thus, GPs’ greater involvement with these populations may first affect other health issues consistent with risk assessment and disease prevalence.”

In the United States, colorectal cancer screening is recommended starting at age 50 for people at average risk for the disease, but sooner for most people at increased risk because of family history or certain medical conditions such as diabetes and inflammatory bowel disease, according to the American Cancer Society. That group also estimates that one-third of adults eligible for colorectal cancer screening in the U.S. have never been screened.

This year, there will be approximately 39,910 cases of rectal cancer diagnosed, and 95,520 new cases of colon cancer, in the U.S., according to the American Cancer Society. – by Janel Miller

References: “Colorectal cancer facts and figures.” Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2017-2019.pdf. Accessed Aug. 31, 2017.

Disclosure: The researchers report no relevant disclosures.