Offering Annual Fecal Occult Blood Tests at Annual Flu Shot Clinics Increases Colorectal Cancer Screening Rates

Department of Family and Community Medicine, University of California San Francisco, San Francisco, California 94143, USA.
The Annals of Family Medicine (Impact Factor: 5.43). 01/2009; 7(1):17-23. DOI: 10.1370/afm.934
Source: PubMed


We wanted to determine whether providing home fecal occult blood test (FOBT) kits to eligible patients during influenza inoculation (flu shot) clinics can contribute to higher colorectal cancer screening (CRCS) rates.
The study was time randomized. On 8 dates of an annual flu shot clinic at the San Francisco General Hospital, patients were offered flu shots as usual (control group) and on 9 other dates, patients were offered both flu shots and FOBT kits (intervention group).
The study included 514 patients aged 50 to 79 years, with 246 in the control group and 268 in the intervention group. At the conclusion of flu season, FOBT screening rates increased by 4.4 percentage points from 52.9% at baseline to 57.3% (P = .07) in the control group, and increased by 29.8 percentage points from 54.5% to 84.3% (P <.001) in the intervention group, with the change among intervention participants 25.4 percentage points greater than among control participants (P value for change difference <.001). Among patients initially due for CRCS, 20.7% in the control group and 68.0% in the intervention group were up-to-date at the conclusion of the study (P <.001). In multivariate analyses, the odds ratio for becoming up-to-date with screening in the intervention group (vs the control group) was 11.3 (95% CI, 5.8-22.0).
Offering FOBT kits during flu shot clinics dramatically increased the CRCS rate for flu shot clinic attendees. Pairing home FOBT kits with annual flu shots may be a useful strategy to improve CRCS rates in other primary care or public health settings.

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Available from: Michael B Potter, Dec 28, 2013
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    • "Ten of them compared this intervention with usual care [22, 26, 42, 46, 50, 55, 64, 68–70]. All of them showed a positive effect of the intervention (Table 1). "
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    ABSTRACT: Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancer screening has proven its benefit in terms of incidence and mortality reduction in randomized controlled trials. In fact, it has been recommended by medical organizations either in average-risk or family-risk populations. Success of a screening campaign highly depends on how compliant the target population is. Several factors influence colorectal cancer screening uptake including sociodemographics, provider and healthcare system factors, and psychosocial factors. Awareness of the target population of colorectal cancer and screening is crucial in order to increase screening participation rates. Knowledge about this disease and its prevention has been used across studies as a measurement of public awareness. Some studies found a positive relationship between knowledge about colorectal cancer, risk perception, and attitudes (perceived benefits and barriers against screening) and willingness to participate in a colorectal cancer screening campaign. The mentioned factors are modifiable and therefore susceptible of intervention. In fact, interventional studies focused on average-risk population have tried to increase colorectal cancer screening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancer screening and interventions targeting participants for increasing screening uptake.
    03/2014; 2014:425787. DOI:10.1155/2014/425787
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    • "Scheduling issues may reflect patients' lack of flexibility in scheduling appointments, lack of understanding of the screening process, or inability to navigate the healthcare system. Attempts to make CRCS easier for patients such as offering the stool blood test, enabling direct-access colonoscopy, using patient navigators to assist patients through the process, and combining CRCS with other preventive care services (e.g., flu shots [22]) might increase screening rates. Additionally, we found that a small number of patients expected to receive a call from the endoscopy clinic suggesting a desire for more clinic outreach efforts to schedule patients. "
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    Gastroenterology Research and Practice 01/2012; 2012:895807. DOI:10.1155/2012/895807 · 1.75 Impact Factor
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    • "Eight of the studies involved all three colorectal screening tests (FOBT, FS, and colonoscopy) [29,42-48]. Four studies used FOBT [32,51,52], and one study used colonoscopy [49]. "
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