Evaluating the Effectiveness of One-on-One Conversations to Increase Colorectal Cancer Screening in a Community-Based Clinical Setting

Abstract

The American Cancer Society's 80% by 2018 initiative aims to increase at-home colorectal cancer (CRC) screening.

To assess the effectiveness of one-on-one conversations with patients about CRC screening on compliance with at-home fecal immunochemical tests (FITs).

Federally funded health care center serving a largely minority, urban, underserved population in Vallejo, California.

Patients aged 50 to 75 years were divided into 3 main intervention arms: (1) patients who received a one-on-one in-person consultation to discuss the need for CRC screening and the screening process, as well as a FIT; (2) patients who received a telephone call to discuss the need for CRC screening and the screening process before receiving a FIT in the mail; and (3) patients who were mailed a FIT with a letter explaining the importance of completing the FIT and instructions. The FITs were tracked to see if they were returned to the laboratory for processing, and the rates of return were compared in bivariate analyses using t and χ² tests and in adjusted analyses using logistic regression with bootstrapping.

A total of 3415 patients were included in the study. One-on-one conversations either in person (OR, 24.63; 95% CI, 19.28-31.46) or via telephone (OR, 14.74; 95% CI, 10.96-19.82) were more effective at getting patients to complete the at-home CRC screening than not having one-on-one conversations before receiving the FIT.

Patients may be more likely to complete at-home FITs to screen for CRC if they are first able to discuss the need for screening and the screening process with a health care professional.