Mail-out faecal immunochemical test kits help increase CRC screening

The implementation of an organized mailed faecal immunochemical test (FIT) outreach programme in a safety-net health system appears to increase FIT completion and improve colorectal cancer (CRC) screening, according to a study.

The study included a cohort of 10,771 patients aged 50–75 years that was not up to date (UTD) with CRC screening. These patients were randomly assigned to groups that received the intervention or usual care. The intervention group received an advanced notification call and informational postcard prior to a mailed FIT, whereas usual care was at the discretion of the primary care provider.

Over a follow-up of 2.5 years, the primary outcome of cumulative proportion of FIT completion was higher in the intervention than in the control group (73.2 percent vs 55.1 percent; p<0.001). The proportion of time covered by screening was likewise higher in the intervention group (46.8 percent vs 27.3 percent; difference, 19.6 percent, 95 percent confidence interval [CI], 18.2–20.9).

FITs were more likely to be completed (two completed of two offered) by patients in the intervention group (50.1 percent vs 21.8 percent; p<0.001). However, among patients who did not complete the FIT during the first cycle, only 17.1 percent completed the test during the second outreach cycle.

Finally, the intervention group had a higher overall proportion of abnormal FIT results compared with the usual care group (6.9 percent vs 4.1 percent; p<0.01).

Future studies may focus on longer follow-up and identifying alternative strategies for patients who do not complete FIT.