Evaluation of a home-based colorectal cancer screening intervention in a rural state

Mary E Charlton; Michelle A Mengeling; Thorvardur R Halfdanarson; Nader M Makki; Ashish Malhotra; J Stacey Klutts; Barcey T Levy; Peter J Kaboli

doi:10.1111/jrh.12052

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Evaluation of a home-based colorectal cancer screening intervention in a rural state

Journal article

Peer reviewed

Evaluation of a home-based colorectal cancer screening intervention in a rural state

Mary E Charlton, Michelle A Mengeling, Thorvardur R Halfdanarson, Nader M Makki, Ashish Malhotra, J Stacey Klutts, Barcey T Levy and Peter J Kaboli

The Journal of rural health, Vol.30(3), pp.322-332

2014

DOI: 10.1111/jrh.12052

PMCID: PMC4266988

PMID: 24164375

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https://www.ncbi.nlm.nih.gov/pmc/articles/4266988View

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Abstract

Distance from health care facilities can be a barrier to colorectal cancer (CRC) screening, especially for colonoscopy. Alternatively, an improved at-home stool-based screening tool, the fecal immunochemical test (FIT), requires only a single sample and has a better sensitivity-specificity balance compared to traditional guaiac fecal occult blood tests. Our objective was to determine if FITs mailed to asymptomatic, average-risk patients overdue for screening resulted in higher screening rates versus mailing educational materials alone or no intervention (ie, usual care). Veterans ages 51-64, asymptomatic, at average risk for CRC, overdue for screening and in a veterans administration (VA) catchment area covering a large rural population were randomly assigned to 3 groups: (1) education only (Ed) group: mailed CRC educational materials and a survey of screening history and preferences (N = 499); (2) FIT group: mailed the FIT, plus educational materials and survey (N = 500); and (3) usual care (UC) group: received no mailings (N = 500). At 6 months postintervention, 21% of the FIT group had received CRC screening by any method compared to 6% of the Ed group (and 6% of the UC group) (P < .0001). Of the 105 respondents from the FIT group, 71 (68%) were eligible to take the FIT. Of those, 64 (90%) completed the FIT and 8 (12%) tested positive. This low-intensity intervention of mailing FITs to average risk patients overdue for screening resulted in a significantly higher screening rate than educational materials alone or usual care, and may be of particular interest in rural areas.

Early Detection of Cancer - methods

Veterans

Humans

Middle Aged

Male

Mass Screening - methods

Colorectal Neoplasms - diagnosis

Iowa

Patient Acceptance of Health Care

Health Services Accessibility

Rural Population

Female

Occult Blood

Details

Title: Subtitle: Evaluation of a home-based colorectal cancer screening intervention in a rural state
Creators: Mary E Charlton - VA Office of Rural Health, Rural Health Resource Center-Central Region, and the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Healthcare System, Iowa City, Iowa; Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
Michelle A Mengeling
Thorvardur R Halfdanarson
Nader M Makki
Ashish Malhotra
J Stacey Klutts
Barcey T Levy
Peter J Kaboli
Resource Type: Journal article
Publication Details: The Journal of rural health, Vol.30(3), pp.322-332
DOI: 10.1111/jrh.12052
PMID: 24164375
PMCID: PMC4266988
NLM abbreviation: J Rural Health
ISSN: 0890-765X
eISSN: 1748-0361
Publisher: England
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 2014
Academic Unit: Health Management and Policy; Epidemiology; Pathology; Family and Community Medicine; Internal Medicine
Record Identifier: 9983995173902771

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