title: Direct mailing of faecal occult blood tests for colorectal cancer screening: a randomized population study from Central Italy.
abstract: BACKGROUND
  Sending faecal occult blood tests (FOBT) by mail has been proposed both as a method to increase participation and a way to reduce staff costs in colorectal cancer screening.
  
  
  METHODS
  Two multicentre randomized controlled trials (ISRCTN10351276) were performed: one randomly assigned 3196 individuals who had previously participated in colorectal screening to receive a FOBT kit at home or a standard invitation; in the second, 4219 people aged 50-69 years who did not respond to a screening invitation were either sent a FOBT or a standard recall letter. The cost per returned kit was calculated in each arm.
  
  
  RESULTS
  Participation was higher with direct FOBT mailing in both trials: relative risk 1.11 (95% CI 1.06-1.17) and 1.36 (95% CI 1.16-1.60) for previous responders and non-responders, respectively. The cost per returned kit for previous responders ranged from 4.24€ to 16.10€, and from 3.29€ to 7.36€ with FOBT mailing and standard invitation, respectively, not including staff costs; for non-responders it ranged from 17.13€ to 46.80€, and from 7.36€ to 18.30€ with FOBT mailing and standard recall, respectively.
  
  
  CONCLUSIONS
  The FOBT mailing strategy modestly increased participation. This method can be used on a population of previous responders to reduce personnel costs and workload. When used as a reminder to non-responders, this method increases costs.
authors: Laziosanita – Agency for Public Health, Lazio Region, Rome.
authors: Paolo
authors: P
authors: Giorgi Rossi
authors: Grazia
authors: G
authors: Grazzini
authors: Marcello
authors: M
authors: Anti
authors: Diego
authors: D
authors: Baiocchi
authors: Alessandra
authors: A
authors: Barca
authors: Paola
authors: P
authors: Bellardini
authors: Silvia
authors: S
authors: Brezzi
authors: Laura
authors: L
authors: Camilloni
authors: Patrizia
authors: P
authors: Falini
authors: Vincenzo
authors: V
authors: Maccallini
authors: Paola
authors: P
authors: Mantellini
authors: Daniele
authors: D
authors: Romeo
authors: Tiziana
authors: T
authors: Rubeca
authors: Maria Antonietta
authors: MA
authors: Venditti
mesh_terms: D000368:Aged; D000465:Algorithms; D002277:Carcinoma / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D003625:Data Collection / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D009780:Occult Blood; D010358:Patient Participation / Q000706:statistics & numerical data; D011153:Population; D011177:Postal Service; D013048:Specimen Handling / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data