Two randomized controlled trials for colorectal cancer screening invitations developed using a behavioral science...

Area of Science:

• Public Health
• Behavioral Science
• Cancer Screening

Background:

• Organized colorectal cancer (CRC) screening programs aim to reduce cancer incidence and mortality.
• Mailed invitations are a key component of screening program outreach.
• Optimizing invitation strategies can improve screening uptake.

Purpose of the Study:

• To evaluate the effectiveness of behaviorally informed, targeted invitations versus standard invitations and no invitation for colorectal cancer screening.
• To compare male-specific and unisex invitations for men, and unisex invitations for women within a CRC screening program.

Main Methods:

• Two pragmatic randomized controlled trials were conducted in Ontario, Canada, involving individuals aged 50-74 due for CRC screening.
• Participants were randomized to receive male-specific, unisex, standard invitations, or no invitation.
• Primary outcome was completion of the guaiac fecal occult blood test (gFOBT); secondary outcome was uptake of any colorectal test within 5 months.

Main Results:

• Both male-specific and unisex invitations significantly increased gFOBT completion in men compared to controls (ORs ranging from 5.99 to 7.24).
• Unisex and standard invitations significantly increased gFOBT completion in women compared to controls (ORs of 7.07 and 6.76, respectively).
• Findings were consistent for the secondary outcome of any colorectal test uptake.

Conclusions:

• Mailed invitations are effective in promoting colorectal cancer screening for both men and women.
• Behaviorally informed, targeted invitations demonstrate increased benefit compared to no invitation, enhancing screening program effectiveness.