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Program Tripled Number of Completed At-Home Colon Cancer Tests
People are three times more likely to undergo at-home colon cancer screening if they’re provided a free test, a new study says.
About 30% of patients mailed a free stool test kit completed their screening within six months, compared with about 10% of those who weren’t sent a kit, researchers reported Nov. 25 in JAMA Network Open.
The kit, a fecal immunochemical test (FIT), uses antibodies to detect blood in stool. This blood is an early warning sign of colon cancer, and those who test positive are urged to undergo a colonoscopy.
“Mailed FIT is an excellent complement to usual care screening services,” researcher Alison Brenner, an associate professor at the University of North Carolina School of Medicine, said in a news release. “It reaches a lot of patients who, for whatever reason, aren't getting screened in usual care and significantly increases screening rates.”
Colon cancer can be prevented, by early detection and removal of pre-cancerous polyps inside the GI tract.
Guidelines recommend that adults 45 to 75 undergo regular screening. Thanks to screening, colon cancer rates among seniors 65 and older have declined, but rates among those under 50 have been rising during the past three decades.
Colonoscopy is considered the gold standard of colon cancer screening, because doctors can examine the entire colon and remove polyps during the procedure. Screening is done once every 10 years.
But a colonoscopy involves the use of powerful laxatives to prepare for the procedure, which is performed under sedation. The prospect causes some to skip the screening.
Due to these qualms, doctors also offer stool tests to screen for colon cancer. These tests, taken once a year, can help keep tabs on a person’s cancer risk.
For this study, researchers recruited more than 4,000 people 50 to 75 receiving medical care at low-income health centers in North Carolina.
Half were mailed free FIT kits, and also received support for a follow-up colonoscopy if the test was positive. The other half received usual care, which included a recommendation to undergo colon cancer screening.
After a year, about 35% of those mailed a free kit had taken the FIT test, compared with about 17% of those receiving usual care, researchers said.
The free kit group also had a higher follow-up rate among those with a positive test – 69%, compared with 44% in the control group.
“Reaching a largely unscreened, predominantly low-income population using centralized mailed screening kits and patient navigation for those with abnormal tests can substantially increase guideline-recommended colorectal cancer screening,” researcher Dr. Daniel Reuland, co-director of the UNC Lineberger Carolina Cancer Screening Initiative, said in a news release.
Based on these findings, researchers are looking into ways to expand the program.
“FIT testing is inexpensive, so we anticipate that this kind of outreach will be a very cost-effective way to improve population screening,” Reuland said. “In tandem with this, we’re working to find ways to scale and sustain this kind of intervention to have greater impact."
More information
The U.S. Centers for Disease Control and Prevention has more about colon cancer screening.
SOURCE: University of North Carolina, news release, Nov. 25, 2024
