Improving fecal occult blood testing compliance using a mailed educational reminder

Area of Science:

• Oncology
• Preventive Medicine
• Public Health

Background:

• Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the U.S.
• Screening via fecal occult blood testing (FOBT) is proven to reduce CRC incidence and mortality.
• Low patient compliance with FOBT presents a significant barrier to effective screening.

Purpose of the Study:

• To evaluate the effectiveness of a mailed educational reminder in increasing FOBT card return rates.
• To identify predictors of patient compliance with FOBT screening.

Main Methods:

• A blinded, randomized controlled trial was conducted at the VA Medical Center, San Diego.
• 775 patients aged 50+ referred for FOBT were randomized into usual care or intervention groups.
• The intervention group received a mailed reminder 10 days after FOBT card distribution.

Main Results:

• The intervention group showed a significantly higher return rate (64.6%) compared to the control group (48.4%) (P < 0.001).
• Receiving a mailed reminder and prior FOBT return history were predictors of compliance.
• Current or recent illicit drug use was associated with lower FOBT return rates.

Conclusions:

• A simple mailed educational reminder is an effective strategy to improve FOBT compliance for CRC screening.
• Targeted interventions can enhance participation in CRC screening programs.
• Further research into barriers to screening in specific populations may be warranted.