Direct Mailing of Fecal Occult Blood Tests to Increase Colorectal Cancer Screening

An Evidence-Based Practice

Description

This program used direct mailings of fecal occult blood test (FOBT) kits to increase colorectal cancer screening. Colorectal cancer screening using FOBT and other techniques reduces the risk of death from colorectal cancer, but the screening rate in the general population is low. Non-invasive FOBT screening kits were mailed to the intervention group of residents aged 50 and older, selected randomly from the state driver's license and identification card database. The kit was sent with a a letter emphasizing the importance of screening, a prepaid envelope, and follow-up forms to allow results to be sent to the participant's primary care provider. A subset of participants were mailed reminders to complete kits after one month and two months. A telephone reminder was given after three months if necessary. Questionnaires were sent to participants at baseline (before FOBT kits were mailed) and at one year for followup.

Goal / Mission

The goal of this program was to increase colorectal cancer screening using direct mailings of fecal occult blood test (FOBT) kits for noninvasive colon cancer screening.

Impact

Direct mailing of FOBT kits resulted in an increase in self-reported colon cancer screening adherence.

Results / Accomplishments

Through the program, 1,450 individuals were sent a questionnaire about colorectal cancer screening. Using a randomized controlled study, a control group receiving only the questionnaire was compared to a group receiving FOBT kits by mail and a group receiving FOBT kits and reminders. At baseline, self-reported adherence to FOBT guidelines was 21.5% and overall adherence to any colorectal cancer screening test guidelines was 55.8%. After one year, the change in self-reported FOBT adherence was 1.5% for the control group, 16.9% for the FOBT direct mail group, and 23.2% for the FOBT direct mail with reminders group. The one-year rate changes for self-reported adherence to any colorectal cancer screening test were 7.8% for the control group, 13.2% for the FOBT direct mail group, and 14.1% for the FOBT direct mail with reminders group.

About this Promising Practice

Organization(s)
University of Minnesota School of Public Health
Primary Contact
Timothy Church
Division of Environmental and Occupational Health
University of Minnesota School of Public Health
MMC807, 420 Delaware St., SE
Minneapolis, MN 55455
(612) 626-0900
trc@cccs.umn.edu
http://enhs.umn.edu/
Topics
Health / Cancer
Health / Prevention & Safety
Organization(s)
University of Minnesota School of Public Health
Source
Journal of the National Cancer Institute
Date of publication
May 2004
Date of implementation
2000
Location
Wright County, MN
For more details
http://jnci.oxfordjournals.org/cgi/reprint/96/10/7...
Target Audience
Adults

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Related Content for: Direct Mailing of Fecal Occult Blood Tests to Increase Colorectal Cancer Screening

An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.