Mailed Colorectal Cancer Screening Outreach—In-House or Outsourced?
Mené aux Etats-Unis auprès de 5 127 participants (âge moyen : 54,5 ans ; environ 59 % de femmes), cet essai randomisé compare la performance de deux stratégies de sensibilisation par courrier pour accroître le recours au dépistage du cancer colorectal dans les centres de santé communautaires
Colorectal cancer (CRC) disproportionately affects underserved communities, and lower screening rates contribute to these disparities. Stool-based screening tests, including fecal immunochemical test (FIT) and FIT-DNA, are convenient options that can facilitate screening uptake in underserved populations. Stool-based tests have increased CRC screening rates and decreased racial disparities in CRC incidence and mortality, yet significant gaps remain.In this issue of JAMA Internal Medicine, May and colleagues compare 2 mailed patient outreach strategies for CRC screening at community health centers in Los Angeles County in California and the greater Boston area in Massachusetts. In this pragmatic randomized clinical trial, patients were mailed a FIT or FIT-DNA test. Patients in the FIT group received 3 text messages with additional outreach conducted by clinic staff. Outreach in the FIT-DNA group was managed by the test manufacturer (Exact Sciences) and included scripted telephone calls, text messages, and emails for a median of 10 outreach attempts. More than 5000 patients were randomized; two-thirds were Spanish-speaking, and one-half had Medicaid insurance. Screening participation at 90 days was relatively low overall, but significantly higher in the FIT-DNA group (751 of 2692 [27.9%] vs 550 of 2435 [22.6%] for FIT, P = .02).
JAMA Internal Medicine , éditorial, 2026