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Improving uptake of colorectal cancer screening programmes

▸ Sequist TD, Zaslavsky AM, Marshall R, et al. Patient and physician reminders to promote colorectal cancer screening. Arch Intern Med 2009;169:364–71.

Colorectal cancer is the second most common cause of cancer death in the West. Screening has been introduced in many countries, but there are issues with uptake by patients and implementation by physicians. In this large randomised controlled trial, conducted in a single healthcare organisation, the impact of interventions given to both patients and physicians on subsequent rates of colorectal cancer screening were studied simultaneously for the first time.

Patients aged 50–80 years who had not received colorectal cancer screening, in accordance with time intervals recommended by clinical guidelines, were randomised to receive either no intervention or information about screening, a faecal occult blood test and a telephone number to schedule flexible sigmoidoscopy or colonoscopy. Physicians within the organisation were randomised to receive electronic reminders when consulting with a patient who was overdue for screening, or no intervention. Randomisation was paired, to control for patient characteristics that may affect uptake of screening, and physicians’ current screening rates.

The intervention led to an increase in patient uptake of screening from 38.1% with no intervention to 44.0% in those receiving information. However, there was no increase in …

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