Multilevel Intervention and Outreach for Colorectal Cancer Screening
Menée aux Etats-Unis à partir de données de dossiers médicaux électroniques portant sur 4 002 participants (âge moyen : 59,6 ans ; 56,4 % de femmes), cette étude évalue l'efficacité, du point de vue du taux de tests de dépistage réalisés et du taux de coloscopies effectuées après un test FIT positif, d'une intervention consistant à envoyer par la poste du matériel de sensibilisation au dépistage du cancer colorectal (lettre de présentation, kit de dépistage avec instructions, affranchissement pour le retour et deux lettres de rappel si nécessaire)
Despite the availability of multiple screening options, modalities for colorectal cancer (CRC) screening, of which colonoscopy and fecal immunochemical stool test (FIT) are the most commonly used, adherence to screening for average-risk individuals aged 50 to 75 years remains low, at 68%. Approximately 30 million people in the US who might not otherwise have access to medical services currently receive care at federally qualified health care centers (FQHCs). Colorectal cancer screening rates in this underserved population are even lower, at 40.5%. The disparities in CRC screening were made worse during the COVID-19 pandemic, creating an unmet need to implement evidence-based multilevel interventions to improve CRC screening uptake. This can be achieved through an organized outreach program with identification of screen-eligible individuals using health records from the clinic and a screening program with (1) a mailed invitation, (2) a mailed FIT kit so patients can complete a FIT from their homes, (3) reminder calls or letter, and (4) navigation to a diagnostic colonoscopy.
JAMA Network Open , éditorial en libre accès, 2023