The effect of mailed outreach on FIT completion among patients aged 45-50 in a safety net healthcare system.

IF 2.2 4区 医学 Q3 ONCOLOGY Cancer Causes & Control Pub Date : 2024-10-01 Epub Date: 2024-06-01 DOI:10.1007/s10552-024-01889-x
Sean P McClellan, Tanya Khan, Henry Rafferty, Jonathan Wong, Sylvia La, Shreya Patel, Ma Somsouk
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Abstract

Purpose: Colorectal cancer screening is recommended starting at age 45, but there has been little research on strategies to promote screening in patients younger than 50.

Methods: An outreach program quasi-randomly assigned patients aged 45-50 without recent fecal immunochemical test (FIT), colonoscopy or contraindications to screening to two intervention arms: electronic outreach with email and text (electronic outreach only) versus electronic outreach plus mailed outreach with FIT, an instructional letter and a prepaid return envelope (mailed + electronic outreach). In response to known disparities in screening uptake, all Black patients were assigned to receive mailed + electronic outreach.

Results: Among patients quasi-randomly assigned to an intervention (non-Black patients), the 180-day FIT completion rate was 18.8% in the electronic outreach only group (n = 1,318) and 25.0% in the mailed + electronic outreach group (n = 1,364) (difference 6.2% [95% CI 3.0, 9.4]). FIT completion was 16.6% among Black patients (n = 469), 8.4% (95% CI 4.1, 12.6) lower than among non-Black patients also assigned to mailed + electronic outreach.

Conclusion: Among patients aged 45-50, mailed + electronic outreach had a greater effect on FIT completion than electronic outreach alone. Crossover between intervention groups likely lead to an underestimation of the effect of mailed outreach.

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邮寄宣传对安全网医疗系统中 45-50 岁患者完成 FIT 的影响。
目的:建议从 45 岁开始进行结直肠癌筛查,但对 50 岁以下患者的筛查推广策略研究甚少:一项推广计划将 45-50 岁、近期未进行粪便免疫化学试验 (FIT)、结肠镜检查或筛查禁忌症的患者准随机分配到两个干预组:使用电子邮件和文本的电子推广(仅电子推广)与使用 FIT、说明信和预付费回邮信封的邮寄推广(邮寄+电子推广)。针对已知的筛查接受率差异,所有黑人患者都被分配接受邮寄+电子宣传:在被准随机分配到干预措施的患者(非黑人患者)中,仅接受电子宣传组(n = 1,318 人)的 180 天 FIT 完成率为 18.8%,而接受邮寄+电子宣传组(n = 1,364 人)的完成率为 25.0%(差异为 6.2% [95% CI 3.0, 9.4])。黑人患者的 FIT 完成率为 16.6%(n = 469),比同样接受邮寄+电子宣传的非黑人患者低 8.4% (95% CI 4.1, 12.6):结论:在 45-50 岁的患者中,邮寄+电子宣传对 FIT 完成率的影响大于单独的电子宣传。干预组之间的交叉可能会导致低估邮寄宣传的效果。
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来源期刊
Cancer Causes & Control
Cancer Causes & Control 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.90
自引率
4.30%
发文量
130
审稿时长
6.6 months
期刊介绍: Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach. The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues. The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts. Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.
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