Simple, automated telephone reminders can increase colon cancer screening rates by 30 percent, according to a Kaiser Permanente Center for Health Research study funded by the National Cancer Institute that appears in the July print edition of Medical Care.
The study – which is the first to examine whether automated calls can increase screening for colon cancer – involved nearly 6,000 Kaiser Permanente members in Oregon and Washington who were overdue for screening. Half received up to three reminder calls stressing the importance of screening and offering them an at-home kit to detect blood in the stool. Within six months, 22.5 percent of people who received reminder calls ordered and completed a stool card test, compared to only 16 percent of those who did not receive reminder calls.
"Most Americans who should be screened for colon cancer are not being screened. If everyone who is eligible for screening received reminder calls through a program like this one we could screen millions of additional people," said study lead author David Mosen, PhD, MPH, an investigator at the Kaiser Permanente Center for Health Research. "And because the calls are automated, they can be delivered to large numbers of people in a short period of time."
Colon cancer is the second leading cause of cancer death in the United States, claiming more than 52,000 lives a year. The U.S. Preventive Services Task Force urges Americans to start screening at age 50, unless they are at high risk, in which case they should be screened earlier.
There are several screening methods available, including: colonoscopy, where a tube is inserted into the rectum to examine the entire colon; sigmoidoscopy, which examines the lower colon; and fecal occult blood tests, a non-invasive test to detect blood in the stool. FOBT, which was the test used in this study, is often recommended as a first step, and requires people to place stool samples on cards and then send the cards to a lab.
"The stool test is easy to take, but many people see it as unpleasant. This study shows that simple, automated calls motivate more people to take the test, and that means we will detect more cancers at an early stage when we can still save lives," said Adrianne Feldstein, MD, the study's principal author and a researcher at the Kaiser Permanente Center for Health Research.
The study, conducted in 2008, was so successful that Kaiser Permanente in Oregon and Washington now is using the automated phone calls to remind all members who are overdue for colon cancer screening.