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Combination of patient, provider outreach boosts CRC screening in high-risk individuals
Recent data presented at Digestive Disease Week in Chicago, IL showed that a multicomponent strategy, including outreach to both the patient and healthcare provider, successfully increased colorectal cancer (CRC) screening in high-risk individuals with a family history of the disease who were overdue for a colonoscopy.
While CRC incidence and mortality have decreased in the US with more health system interventions directed towards improving CRC screening rates, these interventions are often focused at average-risk individuals, therefore excluding those with a family history of the disease. In Canada, population-based screening programs are similarly focused on increasing CRC screening rates in average-risk individuals, and there are no established interventions to increasing screening participation in high-risk individuals.
The researchers conducted their research at an academic health center in the US and included 150 primary care patients who were overdue for their colonoscopies and excluded from the center’s fecal immunochemical test (FIT) outreach.
In order to compare outreach strategies, researchers randomly assigned patients to two intervention groups:
a. Group 1: an electronic health record reminder was sent to the patient’s primary care provider with an overdue colonoscopy order as well as a reminder to the patient via mail and the online patient portal to schedule a colonoscopy.
b. Group 2: received the same outreach as group 1, in addition to an education document on familial risk for CRC and information about the colonoscopy procedure.
Colonoscopy completion rates were 12.2% in group 1 and 14.5% in group 2, with 52 colonoscopies ordered (70.3%) in group 1 compared to 57 (76%) in group 2.
Take home message
The study underlines the importance of targeted interventions to increase CRC screening participation in high-risk individuals with a family history of CRC. The combination of patient and healthcare provider outreach was able to engage individuals at high-risk for the disease to complete their screening. The researchers note that the addition of the educational resource did not add significant benefit and the extra resource may not be needed to achieve the intended results. This demonstrates that a simple intervention involving a reminder on the part of both the patient and the healthcare provider may be enough to make a meaningful difference.