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Mail and electronic reminders may increase colon cancer screening
Date:2/23/2009

Mailed reminders to patients appear to promote colon cancer screening, according to a report in the February 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, electronic reminders to physicians appear to increase screening among patients with more frequent primary care visits.

"Colorectal cancer is the secondary leading cause of cancer mortality [death] in the United States," according to background information in the article. "Screening programs involving fecal occult blood testing, flexible sigmoidoscopy and colonoscopy lower the incidence of colorectal cancer by removing precancerous adenomas, detect cancers at more curable early stages and reduce colorectal cancer mortality." Although national guidelines suggest that average-risk adults age 50 and older should be screened for colorectal cancer, only 60 percent report up-to-date testing.

Thomas D. Sequist, M.D., M.P.H., of Brigham and Women's Hospital, Harvard Vanguard Medical Associates and Harvard Medical School, Boston, and colleagues studied screening rates and colorectal adenoma (tumor) detection for 21,860 patients (age 50 to 80) of 110 physicians from April 2006 to June 2007. Fifty-five physicians were randomly assigned to receive electronic reminders during office visits with patients overdue for screening. Additionally, 10,930 patients were randomly assigned to receive mailings containing an educational pamphlet, a fecal occult blood test kit and instructions for direct scheduling of flexible sigmoidoscopy or colonoscopy. Screening rates and detection of colorectal adenomas (tumors) were noted 15 months after the start of the intervention.

Screening rates for patients who received mailings were higher than for those who did not (44 percent vs. 38.1 percent). The mailings were more effective among older patientspatients age 50 to 59 experienced a 3.7 percent increase, patients age 60 to 69 had a 7.3 percent increase an
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Contact: David Cameron
david_cameron@hms.harvard.edu
617-432-0441
JAMA and Archives Journals
Source:Eurekalert

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