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Improving Colorectal Cancer Screening in a Rural Setting: A Randomized Study.
Kelly A Hirko1, Sue A Lennon2, Todd Lucas3
1Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan.
American Journal of Preventive Medicine
|July 21, 2020
Summary
A mailed motivational letter significantly boosted colorectal cancer screening rates in rural areas. This intervention improved screening participation by 49%, offering a promising strategy to reduce cancer disparities.
Area of Science:
- Public Health
- Preventive Medicine
- Health Disparities
Background:
- Colorectal cancer screening is crucial for early detection and mortality reduction.
- Adherence to screening recommendations is notably low, especially in rural populations.
Purpose of the Study:
- To evaluate the effectiveness of a mailed motivational messaging intervention on colorectal cancer screening participation.
- To address low screening adherence in a largely rural health system.
Main Methods:
- A randomized controlled trial (RCT) involving 7,812 adults aged 50-75 years.
- Intervention group received a motivational letter with a free at-home fecal immunochemical test option; control group received standard invitation.
- Screening participation was tracked via electronic medical records for 6 months.
Main Results:
- Colorectal cancer screening participation increased significantly in the intervention group (30.1%) compared to the control group (22.5%).
- Individuals in the intervention group had 49% higher odds of being screened (OR=1.49).
- 13.2 invitations were needed for one additional screening; 66.1% of mailed test kits were returned.
Conclusions:
- A mailed motivational messaging letter, coupled with an accessible screening alternative, effectively increased colorectal cancer screening in a rural community.
- This approach shows potential for reducing colorectal cancer disparities.
- Motivational messaging via mail is a viable strategy to enhance screening rates.
