Promoting FIT colorectal cancer screening
Mené aux Etats-Unis auprès de 41 193 participants (âge moyen : 58,5 ans ; 22 994 femmes), cet essai multicentrique évalue, du point de vue de la proportion de personnes ayant participé à un test immunochimique de recherche de sang occulte dans les selles (FIT) et du taux de dépistage du cancer colorectal, l'efficacité d'une intervention consistant à identifier les adultes éligibles à l'aide du dossier médical électronique et à leur envoyer un courrier de sensibilisation, un test FIT et éventuellement une lettre de rappel
Rates of colorectal cancer (CRC) screening are low, particularly among the underserved. Of the several available and equally effective CRC screening options,1 fecal-based testing, such as fecal immunochemical testing (FIT) is the most convenient because it does not require a clinical visit, taking time off from work, or being escorted back and forth from the procedure owing to the widespread use of anesthesia for colonoscopy.2 In this STOP CRC project the investigators randomized federally qualified health clinics to practice improvement efforts or usual care.3 For the practice improvement clinics, tools were built into the electronic medical record to identify eligible patients and mail them materials including the actual FIT tests. In the lagged data (which allowed enough time for the clinics to implement the new processes), the rates of FIT screening were 15.9% for usual care compared with 21.6% in the intervention clinics. The number needed to mail to achieve a completed FIT was 4.8 overall, and 4.0 in clinics that mailed a FIT reminder. Most (59%) of those with positive FIT completed a colonoscopy. The success of this intervention should encourage health centers to engage clinicians and patients to increase CRC screening efforts.
JAMA Internal Medicine , éditorial, 2017