BACKGROUND:Cancer screening rates are suboptimal for low-income patients. OBJECTIVE: To assess an intervention to increase cancer screening among patients in a safety-net primary care practice. DESIGN:Patients at an inner-city family practice who were overdue for cancer screening were randomized to intervention or usual care. Screening rates at 1 year were compared using the chi-square test, and multivariable analysis was performed to adjust for patient factors. SUBJECTS:All average-risk patients at an inner-city family practice overdue for mammography or colorectal cancer (CRC) screening. Patients' ages were 40 to 74 years (mean 53.9, SD 8.7) including 40.8 % African Americans, 4.2 % Latinos, 23.2 % with Medicaid and 10.9 % without any form of insurance. INTERVENTION: The 6-month intervention to promote cancer screening included letters, automated phone calls, prompts and a mailed Fecal Immunochemical Testing (FIT) Kit. MAIN MEASURES: Rates of cancer screening at 1 year. KEY RESULTS:Three hundred sixty-six patients overdue for screening were randomly assigned to intervention (n = 185) or usual care (n = 181). Primary analysis revealed significantly higher rates of cancer screening in intervention subjects: 29.7 % vs. 16.7 % for mammography (p = 0.034) and 37.7 % vs. 16.7 % for CRC screening (p = 0.0002). In the intervention group, 20 % of mammography screenings and 9.3 % of CRC screenings occurred at the early assessment, while the remainder occurred after repeated interventions. Within the CRC intervention group 44 % of screened patients used the mailed FIT kit. On multivariable analysis the CRC screening rates remained significantly higher in the intervention group, while the breast cancer screening rates were not statistically different. CONCLUSIONS: A multimodal intervention significantly increased CRC screening rates among patients in a safety-net primary care practice. These results suggest that relatively inexpensive letters and automated calls can be combined for a larger effect. Results also suggest that mailed screening kits may be a promising way to increase average-risk CRC screening.
RCT Entities:
BACKGROUND:Cancer screening rates are suboptimal for low-income patients. OBJECTIVE: To assess an intervention to increase cancer screening among patients in a safety-net primary care practice. DESIGN:Patients at an inner-city family practice who were overdue for cancer screening were randomized to intervention or usual care. Screening rates at 1 year were compared using the chi-square test, and multivariable analysis was performed to adjust for patient factors. SUBJECTS: All average-risk patients at an inner-city family practice overdue for mammography or colorectal cancer (CRC) screening. Patients' ages were 40 to 74 years (mean 53.9, SD 8.7) including 40.8 % African Americans, 4.2 % Latinos, 23.2 % with Medicaid and 10.9 % without any form of insurance. INTERVENTION: The 6-month intervention to promote cancer screening included letters, automated phone calls, prompts and a mailed Fecal Immunochemical Testing (FIT) Kit. MAIN MEASURES: Rates of cancer screening at 1 year. KEY RESULTS: Three hundred sixty-six patients overdue for screening were randomly assigned to intervention (n = 185) or usual care (n = 181). Primary analysis revealed significantly higher rates of cancer screening in intervention subjects: 29.7 % vs. 16.7 % for mammography (p = 0.034) and 37.7 % vs. 16.7 % for CRC screening (p = 0.0002). In the intervention group, 20 % of mammography screenings and 9.3 % of CRC screenings occurred at the early assessment, while the remainder occurred after repeated interventions. Within the CRC intervention group 44 % of screened patients used the mailed FIT kit. On multivariable analysis the CRC screening rates remained significantly higher in the intervention group, while the breast cancer screening rates were not statistically different. CONCLUSIONS: A multimodal intervention significantly increased CRC screening rates among patients in a safety-net primary care practice. These results suggest that relatively inexpensive letters and automated calls can be combined for a larger effect. Results also suggest that mailed screening kits may be a promising way to increase average-risk CRC screening.
Authors: David M Mosen; Adrianne C Feldstein; Nancy Perrin; A Gabriela Rosales; David H Smith; Elizabeth G Liles; Jennifer L Schneider; Jennifer E Lafata; Ronald E Myers; Michael Kositch; Thomas Hickey; Russell E Glasgow Journal: Med Care Date: 2010-07 Impact factor: 2.983
Authors: Debra J Holden; Daniel E Jonas; Deborah S Porterfield; Daniel Reuland; Russell Harris Journal: Ann Intern Med Date: 2010-04-13 Impact factor: 25.391
Authors: Steven R Simon; Fang Zhang; Stephen B Soumerai; Arthur Ensroth; Lydia Bernstein; Robert H Fletcher; Dennis Ross-Degnan Journal: Arch Intern Med Date: 2010-02-08
Authors: Nasar U Ahmed; Gillian Haber; Kofi A Semenya; Margaret K Hargreaves Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-06-29 Impact factor: 4.254
Authors: Limin X Clegg; Marsha E Reichman; Barry A Miller; Benjamin F Hankey; Gopal K Singh; Yi Dan Lin; Marc T Goodman; Charles F Lynch; Stephen M Schwartz; Vivien W Chen; Leslie Bernstein; Scarlett L Gomez; John J Graff; Charles C Lin; Norman J Johnson; Brenda K Edwards Journal: Cancer Causes Control Date: 2008-11-12 Impact factor: 2.506
Authors: Terry C Davis; Connie L Arnold; Michael S Wolf; Charles L Bennett; Dachao Liu; Alfred Rademaker Journal: J Community Support Oncol Date: 2015-02
Authors: Samir Gupta; Stacie Miller; Mark Koch; Emily Berry; Paula Anderson; Sandi L Pruitt; Eric Borton; Amy E Hughes; Elizabeth Carter; Sylvia Hernandez; Helen Pozos; Ethan A Halm; Ayelet Gneezy; Alicea J Lieberman; Celette Sugg Skinner; Keith Argenbright; Bijal Balasubramanian Journal: Am J Gastroenterol Date: 2016-08-02 Impact factor: 10.864
Authors: Robert J Fortuna; Amna Idris; Paul Winters; Sharon G Humiston; Steven Scofield; Samantha Hendren; Patricia Ford; Shirley X L Li; Kevin Fiscella Journal: J Gen Intern Med Date: 2014-01 Impact factor: 5.128
Authors: Connie L Arnold; Alfred W Rademaker; James D Morris; Laurie Anne Ferguson; Gary Wiltz; Terry C Davis Journal: Cancer Date: 2019-07-29 Impact factor: 6.860
Authors: Michael K Dougherty; Alison T Brenner; Seth D Crockett; Shivani Gupta; Stephanie B Wheeler; Manny Coker-Schwimmer; Laura Cubillos; Teri Malo; Daniel S Reuland Journal: JAMA Intern Med Date: 2018-12-01 Impact factor: 21.873