A randomized controlled trial to improve colon cancer screening in rural family medicine: an Iowa Research Network (IRENE) study

Barcey T Levy; Yinghui Xu; Jeanette M Daly; John W Ely

doi:10.3122/jabfm.2013.05.130041

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A randomized controlled trial to improve colon cancer screening in rural family medicine: an Iowa Research Network (IRENE) study

Journal article

Open access

A randomized controlled trial to improve colon cancer screening in rural family medicine: an Iowa Research Network (IRENE) study

Barcey T Levy, Yinghui Xu, Jeanette M Daly and John W Ely

Journal of the American Board of Family Medicine, Vol.26(5), pp.486-497

09/2013

DOI: 10.3122/jabfm.2013.05.130041

PMID: 24004700

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Abstract

Many adults have not been screened for colon cancer, a potentially preventable cause of death. This was a randomized controlled trial conducted between December 2008 and April 2011 to improve CRC screening in 16 rural family physician offices. Subjects due for CRC screening were randomized within each practice to 1 of 4 groups: (1) usual care; (2) physician chart reminder; (3) physician chart reminder, mailed education, CRC reminder magnet, and fecal immunochemical test (FIT) (mailed education/FIT); or (4) all the preceding plus a structured telephone call to the patient from project staff to provide education, assess interest in screening, explain the screening tests, and address barriers (mailed education/FIT plus phone call). The main outcome was completion of any CRC screening. This study enrolled 743 patients. CRC screening was completed by 17.8% in the usual care group, 20.5% in the chart reminder group, 56.5% in the mailed education/FIT group, and 57.2% in the mailed education/FIT plus phone call group. We found no effect from the chart reminder compared with usual care (odds ratio [OR], 1.2; 95% confidence interval [CI], 0.7-2.0); and a beneficial effect from the mailed education/FIT (OR, 6.0; 95% CI, 3.7-9.6) and the mailed education/FIT plus phone call (OR, 6.2; 95% CI, 3.8-9.9). Both FIT and colonoscopy rates increased significantly in both mailed education groups. CRC screening rates increased significantly among patients who were overdue for screening after they received mailed educational materials and a FIT. The addition of a phone call did not further increase screening rates.

Early Detection of Cancer - methods

Humans

Middle Aged

Colonic Neoplasms - diagnosis

Mass Screening - statistics & numerical data

Male

Mass Screening - methods

Iowa

Reminder Systems

Colonoscopy - statistics & numerical data

Quality Improvement

Rural Population

Female

Occult Blood

Health Education

Rural Health Services

Details

Title: Subtitle: A randomized controlled trial to improve colon cancer screening in rural family medicine: an Iowa Research Network (IRENE) study
Creators: Barcey T Levy - Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA. barcey-levy@uiowa.edu
Yinghui Xu
Jeanette M Daly
John W Ely
Resource Type: Journal article
Publication Details: Journal of the American Board of Family Medicine, Vol.26(5), pp.486-497
Publisher: United States
DOI: 10.3122/jabfm.2013.05.130041
PMID: 24004700
ISSN: 1557-2625
eISSN: 1558-7118
Language: English
Date published: 09/2013
Academic Unit: Epidemiology; Family and Community Medicine
Record Identifier: 9984025281202771

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