Direct mailing of fecal occult blood test (FOBT) kits to patients eligible for colorectal cancer screening appears to be efficacious for improving screening in historically underserved (government codespeak for 'poor') communities.
A randomized control trial including 202 patients at a community health clinic in Chicago, Ill., found patients assigned to an outreach intervention consisting of the mailing of FOBT kits with follow-up telephone calls to initial non-responders had a 30 percent screening rate, compared with a 5 percent screening rate among patients in the usual-care group.
Although prior studies have shown the direct-to-patient mailing of FOBT kits can lead to higher colorectal cancer screening rates in predominantly white, middle-class or well-insured populations, this study adds to the existing literature by demonstrating that this outreach strategy can significantly improve screening rates even among economically disadvantaged patients from a wide range of racial, ethnic and cultural backgrounds.
This finding is especially important given the marked disparities in colorectal screening among racial and ethnic minorities, individuals with lower income and educational attainment, the uninsured and individuals born outside the United States.
Paper: 'Program to Improve Colorectal Cancer Screening in a Low-Income, Racially Diverse Population: A Randomized Controlled Trial' By Muriel Jean-Jacques, MD, MA, et al September/October 2012 Annals of Family Medicine
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