Attempting the improbable: offering colorectal cancer screening to all appropriate patients

Screening tests, to be most effective, must be offered to all eligible patients. The goal of this study was to increase patient compliance with screening flexible sigmoidoscopy and fecal occult blood testing by offering these tests to all eligible patients over age 50 during office visits. During a twelve-week period, 546 patients were seen by 18 family practice resident and faculty physicians who had been randomly assigned to two intervention groups and one control group. During all visits with patients in the intervention groups, reminders were used to prompt physicians to offer the two screening tests. Patients in one of the groups also received a recall letter two weeks after the visit. The screening tests were offered to 58% of the eligible patients. Significantly more patients in the intervention groups completed the sigmoidoscopy (29% vs 2%) and fecal occult blood testing (56% vs 17%) compared with the control group patients.