A screening test mailed to participants that looks for blood and DNA markers of cancer in human stool, Fecal immunochemical test (FIT)-DNA, was more popular than a test looking for blood alone, show results from a study carried out in Boston and Los Angeles.
The community-based study, published in JAMA Internal Medicine, showed that uptake of the FIT-DNA test at 90 days was 28% versus 23% in the FIT test group that looks at blood alone.
“Stool-based screening tests are common in community health centers where access to colonoscopy is limited…. Although FIT is typically provided during a visit, there is increasing evidence for mailed outreach to increase uptake,” explain lead author Jennifer Haas, MD, of the Division of Internal Medicine in the Mass General Brigham Department of Medicine.
“FIT-DNA is a newer stool-based screening test, with increasing popularity in community health centers, commonly performed every three years and mailed directly to patients by the manufacturer.”
This study aimed to assess the uptake of mailed FIT and FIT-DNA tests in 5127 participants from the greater Boston area in Massachusetts and Los Angeles County in California. English or Spanish speaking participants aged 45–75 years were eligible.
Some participants were sent FIT‑DNA kits along with the manufacturer’s standard outreach program, while others received FIT kits by mail plus automated text reminders from the study team. Those with abnormal results on either test were directed to have a colonoscopy.
The uptake of the FIT-DNA and FIT tests at 90 and 180 days was 28% and 32%, respectively in the FIT-DNA group and a respective 23% and 27% in the FIT group. Overall, screening was higher in the Boston-based participants than the Los Angeles participants.
The researchers believe the FIT-DNA test may have been more popular due to good outreach support of that test and the fact that it is only needed once every three years.
Notably, only 36% of people referred for colonoscopy from both the FIT and FIT-DNA groups actually attended an appointment, which the researchers say is “suboptimal.”
“Effective screening is essential because it allows us to catch and treat cancer early,” Haas said in a press statement. “There are evidence-backed, preventive interventions for colorectal cancer, but they need to be implemented systematically in a way that addresses barriers for both the community health centers and the patients they are serving. The best screening test will always be the one that people are able to complete.”
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