title: Uptake and positive predictive value of fecal occult blood tests: A randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study is to compare the uptake of three mailed high-sensitivity fecal occult blood tests (FOBTs).
  
  
  METHODS
  We conducted a parallel 3-arm randomized controlled trial in an integrated healthcare delivery system in Washington State. From January 2010 through February 2011, automated data were used to identify potentially eligible patients aged 50-74 due for colorectal cancer screening. Participants were mailed one of three FOBT kits (1-sample OC-Auto® fecal immunochemical test [FIT], 2-sample InSure® FIT, or 3-sample guaiac Hemoccult SENSA®), instructions, and a postage-paid return envelope. We performed a modified intent-to-treat analysis with return of any FOBT within 6 months of randomization as the primary outcome.
  
  
  RESULTS
  Of the 9922 people invited, 2873 returned surveys, 2263 were randomized, and 2234 were analyzed. FOBTs were returned by 1431 participants. At 6 months post-randomization, the proportions screened by any FOBT were 0.69 (95% confidence interval [CI] 0.66-0.72) for the OC-Auto arm, 0.64 (95% CI: 0.61-0.68) for the InSure arm, and 0.61 (95% CI: 0.58-0.65) for the Hemoccult SENSA arm (P<0.001 for any difference). Pairwise comparisons showed significant differences between the OC-Auto group and each of the other groups after correction for multiple comparisons.
  
  
  CONCLUSIONS
  Uptake of mailed FOBT kits varies by kit type.
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA 98101, USA; Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195, USA. Electronic address: Chubak.j@ghc.org.
authors.forename: Jessica
authors.initials: J
authors.lastname: Chubak
authors.forename: Andy
authors.initials: A
authors.lastname: Bogart
authors.forename: Sharon
authors.initials: S
authors.lastname: Fuller
authors.forename: Sharon S
authors.initials: SS
authors.lastname: Laing
authors.forename: Beverly B
authors.initials: BB
authors.lastname: Green
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D019033:Delivery of Health Care, Integrated; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D057240:Patient Preference; D011177:Postal Service; D011237:Predictive Value of Tests; D014600:Utilization Review; D014861:Washington
keywords: Colorectal neoplasms; Early detection of cancer; Intervention studies
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