Prompts for colorectal cancer screening effective, but only temporarily

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Sending patients reminders to undergo colorectal cancer screening can increase screening rates in the short term, according to two reports published online ahead of an April 11, 2011, print date in Archives of Internal Medicine.

In one project, Kenzie A. Cameron, PhD, MPH, and colleagues from the Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center at Northwestern University launched a combined reminder/outreach intervention in a general internal medicine practice. The 628 participants, aged 50 to 79 years, were overdue for screening colonoscopy. As part of the study, half the group was mailed a reminder letter from their primary care physician as well as a brochure and digital video disc about colorectal cancer and colorectal cancer screening, and then received a follow-up telephone call. The remaining patients did not receive any of these materials until after the study period.

At 3 months, 9.9% of the intervention group had undergone screening, compared with 3.2% of the control group. Three months later, screening rates rose to 18.2% and 12.1%, respectively. Nevertheless, pointed out the researchers, the screening rate remained low (

In the second report, Thomas D. Sequist, MD, MPH, led another randomized, controlled trial involving patients who were also overdue for colorectal cancer screening. Some of the 1,103 subjects, aged 50 to 75 years, received a single electronic message that highlighted their overdue status and included a link to a Web-based tool that allowed them to assess their personal risk for the disease.

One month later, the screening rate for patients who received the electronic messages was 8.3%, compared with 0.2% for those who received no such communication. “But this difference was no longer significant at 4 months (15.8% vs 12.1%),” reported the investigators ( They concluded that sending electronic messages to patients produces an initial increase in colorectal cancer screening rates, but that this effect is not sustained over time.   

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