Automated phone calls may help increase colon cancer screening

Automated reminder calls may increase colon cancer screening rates by 30%, according to a study published in Medical Care (2010 Jul;48(7):604-10).

The study, conducted at Kaiser Permanente Center for Health Research, involved 6,000 members 51-80 years old who received a call because they had not had a colonoscopy in the last 10 years, a flexible sigmoidoscopy or barium enema in the last 5 years, a fecal occult blood test (FOBT) in the past 12 months, or a clinical referral for FOBT or barium enema within the last 3 months.

During the automated call, which lasted about 1 minute and was spoken in English or Spanish, members were told about the importance of screening and were asked to press a number on their phone if they wanted to order a free at-home kit to detect blood in the stool. Those who did not order and complete the kit within 6 weeks received a second call. After another 6 weeks, those who still had not ordered a kit received a third call.

Half the members received up to three reminder calls that reiterated the importance of screening and again offered them an at-home kit. Those in the control group, who were of similar age, sex, BMI and race, did not receive automated calls but may have received reminders from their primary care physicians.

“Most Americans who should be screened for colon cancer are not being screened,” said David Mosen, PhD, MPH, an investigator at the Kaiser Permanente Center for Health Research. “If everyone who is eligible for screening received reminder calls through a program like this one, we could screen millions of additional people.”

Researchers reported that within 6 months, 22.5% of people who received reminder calls ordered and completed a stool card test, compared to only 16% of those who did not receive reminder calls.

“The stool test is easy to take, but many people see it as unpleasant,” said Adrianne Feldstein, MD, the study's principal author and a researcher at the Kaiser Permanente Center for Health Research. “This study shows that simple, automated calls motivate more people to take the test, and that means we will detect more cancers at an early stage when we can still save lives.”

The success of Dr. Feldstein's study has resulted in Kaiser Permanente using automated phone calls to remind all members in Oregon and Washington who are overdue for colon cancer screening.

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