healthmedicinet

Colon cancer screening rates increased by nearly 40 percent when free stool tests were mailed to patients’ homes, according to results of a pilot study published today in the journal BMC Cancer.

The study, funded by the National Institutes of Health (NIH), included 869 patients who received their health care from community health centers in the Portland, Ore. metropolitan area. The clinics serve many Latino patients who live below the poverty level. About half of them have no health insurance.

“We are very happy that so many of the patients who received the screening kits in the mail actually completed the tests and mailed them back,” said Gloria Coronado, PhD, lead author and senior investigator at the Kaiser Permanente Center for Health Research. “Colon cancer screening rates are low among the general population, but even lower among minorities and those without health insurance. This sets the stage for our larger STOP Colon Cancer study, which aims to increase screening among thousands more patients who receive their care from community health clinics.”

The pilot study was conducted in three clinics operated by Virginia Garcia Memorial Health Center. In the first clinic, 112 patients received an introductory letter written in English and Spanish, and two weeks later they received a stool test. If they hadn’t returned the tests within three weeks, these patients received a reminder postcard. In the second clinic, 101 patients received the introductory letters, the mailed stool tests and reminder postcards, as well as an additional phone call if they hadn’t returned the tests within a month. The third clinic, with 656 patients, served as a control. These patients received no stool test in the mail but may have been given a test during a routine clinic visit.

Only 1 percent of the patients in the control clinic completed a screening stool test, compared to 39 percent who received screening tests in the mail and 37 percent of patients who received the screening tests with the additional phone reminder.

Colorectal cancer is the second leading cause of cancer death in the United States, according to the Centers for Disease Control and Prevention. Yet one in three adults is not adequately screened. A 2012 CDC survey found that 66 percent of non-Latino whites were adequately screened, compared to 53 percent of Latinos and 37 percent of uninsured patients.

“Many patients don’t understand that a simple stool test called FIT, or fecal immunochemical test, can save their lives,” said Tanya Kapka, MD, MPH, co-author and family physician at Virginia Garcia Memorial Health Center. “The FIT test can be done at home, it only takes a few minutes, and, if conducted annually, is effective for determining which patients are most likely to have colon cancer.”

Unlike older stool tests, FIT does not require people to restrict their diets or to stop taking medications. The test detects small amounts of blood in the stool. People who test positive on FIT need a follow-up colonoscopy to look for cancer or pre-cancerous polyps.