title: Patient outreach to promote colorectal cancer screening among patients with an expired order for colonoscopy: a randomized controlled trial.
abstract: BACKGROUND
  Targeted interventions to promote colorectal cancer screening among specific populations could increase screening rates. Patients with an expired order for screening colonoscopy might be persuaded to follow through with screening by such an intervention.
  
  
  METHODS
  We conducted a randomized controlled trial of a combined reminder/outreach intervention among patients in a large general internal medicine practice. Participants included 628 patients aged 50 to 79 years with an expired order for screening colonoscopy. Patients were stratified based on receipt of any previous colorectal cancer screening and randomly assigned either to (1) an intervention group that received a mailing containing a reminder letter from their primary care physician, a brochure and digital video disc about colorectal cancer and colorectal cancer screening, and a follow-up telephone call or (2) a usual care control group. The primary outcome was receipt of fecal occult blood testing, sigmoidoscopy, or colonoscopy within 3 months of randomization. Screening outcomes were observed for an additional 3 months (6 months from randomization).
  
  
  RESULTS
  Screening rates at 3 months were 9.9% (31 of 314 patients) in the intervention group and 3.2% (10 of 314 patients) in the control group (rate ratio, 3.1; 95% confidence interval, 1.5-6.2; P = .001). At 6 months, rates were 18.2% (57 of 314 patients) and 12.1% (38 of 314 patients), respectively (rate ratio, 1.5; 95% confidence interval, 1.03-2.2; P = .03).
  
  
  CONCLUSIONS
  Patient outreach to individuals with an expired order for colonoscopy may be an effective tool to modestly increase short-term completion of colorectal cancer screening.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00793455.
authors.affiliation: Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Dr, 10th Floor, Chicago, IL 60611, USA. k-cameron@northwestern.edu
authors.forename: Kenzie A
authors.initials: KA
authors.lastname: Cameron
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Persell
authors.forename: Tiffany
authors.initials: T
authors.lastname: Brown
authors.forename: Jason
authors.initials: J
authors.lastname: Thompson
authors.forename: David W
authors.initials: DW
authors.lastname: Baker
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D017010:Reminder Systems